{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:20:43Z","timestamp":1792657243518,"version":"4.5.0"},"reference-count":75,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T00:00:00Z","timestamp":1584316800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Securing an early accurate diagnosis of diabetic foot infections and assessment of their severity are of paramount importance since these infections can cause great morbidity and potentially mortality and present formidable challenges in surgical and antimicrobial treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In June 2018, we searched the literature using PuEbMed and EMBASE for published studies on the diagnosis of diabetic foot infection. On the basis of predetermined criteria, we reviewed prospective controlled, as well as noncontrolled, studies in any language, seeking translations for those not in English. We then developed evidence statements on the basis of the included papers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From the 4242 records screened, we selected 35 papers that met our inclusion criteria. The quality of all but one of the evidence statements was low because of the weak methodology of nearly all of the studies. The available data suggest that diagnosing diabetic foot infections on the basis of clinical signs and symptoms and classified according to the International Working Group of the Diabetic Foot scheme correlates with the patient's likelihood of ulcer healing, of lower extremity amputation, and risk of death. Elevated levels of selected serum inflammatory markers are supportive, but not diagnostic, of soft tissue or bone infection. In patients with suspected diabetic foot osteomyelitis, both a positive probe\u2010to\u2010bone test and an elevated erythrocyte sedimentation rate are strongly associated with its presence. Culturing tissue samples of soft tissues or bone, when care is taken to avoid contamination, provides more accurate microbiological information than culturing superficial (swab) samples. Plain X\u2010ray remains the first\u2010line imaging examination when there is suspicion of diabetic foot osteomyelitis, but advanced imaging methods help in cases when either the diagnosis or the localization of infection is uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this first reported systematic review on the diagnosis of diabetic foot infections provide some guidance for clinicians, but there is a need for more prospective controlled studies of high quality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dmrr.3281","type":"journal-article","created":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T13:07:41Z","timestamp":1584364061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Diagnosis of infection in the foot in diabetes: a systematic review"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5720-8908","authenticated-orcid":false,"given":"\u00c9ric","family":"Senneville","sequence":"first","affiliation":[{"name":"Gustave Dron Hospital  Tourcoing France"},{"name":"Lille University  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A.","family":"Lipsky","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Washington  Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulfiqarali G.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Abbas Medical Centre, Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Arag\u00f3n\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"La Paloma Hospital  Las Palmas Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Diggle","sequence":"additional","affiliation":[{"name":"Alberta Public Laboratories University of Alberta Hospital  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Embil","sequence":"additional","affiliation":[{"name":"University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeo","family":"Kono","sequence":"additional","affiliation":[{"name":"WHO\u2010Collaborating Centre for Diabetes National Hospital Organization Kyoto Medical Centre  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence A.","family":"Lavery","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center and Parkland Hospital  Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Malone","sequence":"additional","affiliation":[{"name":"School of Medicine, Infectious Diseases and Microbiology Western Sydney University  Sydney New South Wales Australia"},{"name":"South West Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne A.","family":"van Asten","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University Medical Centre University of Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilma","family":"Urban\u010di\u010d\u2010Rovan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"},{"name":"Department of Medical Microbiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar J.G.","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2425"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.12440"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13680"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2706"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2247"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2699"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis346"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2007.02308.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2011.00937.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/511036"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13431"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2010.03123.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-197602000-00002"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2013.0251"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01830.x"},{"key":"e_1_2_10_20_1","first-page":"34","article-title":"Quantitative swab culture versus tissue biopsy: a comparison in chronic wounds","volume":"47","author":"Bill TJ","year":"2001","journal-title":"Ostomy Wound Manage"},{"key":"e_1_2_10_21_1","first-page":"329","article-title":"Correlation of semi\u2010quantitative swab cultures to quantitative swab cultures from chronic wounds","volume":"14","author":"Ratliff C","year":"2002","journal-title":"Wounds"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/498112"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475x.2001.00178.x"},{"key":"e_1_2_10_24_1","article-title":"Needle puncture and transcutaneous bone biopsy cultures are inconsistent in patients with diabetes and suspected osteomyelitis of the foot","volume":"1","author":"Senneville E","year":"2009","journal-title":"Clin Infect Dis."},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2010.12.001"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw445"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-1572"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.7547\/1020369"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrnm.2014.04.015"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2008.09.003"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-2309"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573399811666150713104401"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12545"},{"key":"e_1_2_10_34_1","first-page":"23","article-title":"Serum procollagen type 1 N propeptide: a novel diagnostic test for diabetic foot osteomyelitis \u2010 a case\u2010control study","volume":"30","author":"Hayes OG","year":"2018","journal-title":"J Res Med Sci"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-0532"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01887.x"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079601700103"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11307-009-0268-2"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.15.11.1527"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-3919.152946"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(97)80057-9"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2013.07.002"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0000000000000603"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2017.02.015"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-2108"},{"key":"e_1_2_10_46_1","first-page":"485","article-title":"Diagnosis of osteomyelitis in the diabetic foot with a 99mTc\u2010HMPAO leucocyte scintigraphy combined with a 99mTc\u2010MDP bone scintigraphy","volume":"28","author":"Poirier JY","year":"2002","journal-title":"Diabetes Metab"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/8198714"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.2337\/db12-0771"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2012.03.015"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734613481975"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019437"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-015-2544-1"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.464"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1086\/424846"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100712467980"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-1598"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.213.305"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12536"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.04.008"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.5812\/ijem.13376"},{"key":"e_1_2_10_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.02.060"},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.4103\/jrms.JRMS_906_16"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-007-0840-8"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/7104352"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12717"},{"key":"e_1_2_10_66_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1352"},{"key":"e_1_2_10_67_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-0461"},{"key":"e_1_2_10_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12084"},{"key":"e_1_2_10_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2017.06.026"},{"key":"e_1_2_10_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.04.036"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2018.03.001"},{"key":"e_1_2_10_72_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2010.03150.x"},{"key":"e_1_2_10_73_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2018.05.010"},{"key":"e_1_2_10_74_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-019-03547-6"},{"key":"e_1_2_10_75_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612824666180227094454"},{"key":"e_1_2_10_76_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734618785844"}],"container-title":["Diabetes\/Metabolism Research and Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fdmrr.3281","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dmrr.3281","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dmrr.3281","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dmrr.3281","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T23:35:02Z","timestamp":1694043302000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dmrr.3281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":75,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1002\/dmrr.3281"],"URL":"https:\/\/doi.org\/10.1002\/dmrr.3281","archive":["Portico"],"relation":{},"ISSN":["1520-7552","1520-7560"],"issn-type":[{"value":"1520-7552","type":"print"},{"value":"1520-7560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3]]},"assertion":[{"value":"2019-06-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e3281"}}