{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T07:10:19Z","timestamp":1782803419163,"version":"3.54.5"},"reference-count":51,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2012,4,1]],"date-time":"2012-04-01T00:00:00Z","timestamp":1333238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study evaluated the incidence and factors responsible for plasmid-mediated extended-spectrum \u03b2-lactamase (ESBL) infection among patients with diabetic foot ulcer (DFU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods:<\/jats:title>\n                    <jats:p>\n                      A prospective study was conducted on 162 DFU inpatients treated in a multidisciplinary-based diabetes and endocrinology center at Jawaharlal Nehru Medical College of Aligarh Muslim University, Aligarh, India, during the period of December 2008\u2013March 2011. Detailed history and patient's profile, grade of DFU, co-morbidities and complications, laboratory data, and final outcome were collected. Standard methods were used for culture identification, sensitivity testing, and ESBL detection. Polymerase chain reaction for\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      genes was performed, and the risk factors for\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      gene positivity were determined by univariate analysis with 95% confidence interval.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 127 (78.3%) Enterobacteriaceae members were isolated. The most common isolate was\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      (71; 55.9%), followed by\n                      <jats:italic toggle=\"yes\">Klebsiella<\/jats:italic>\n                      sp. (33; 25.9%) and\n                      <jats:italic toggle=\"yes\">Proteus<\/jats:italic>\n                      sp. (13; 10.2%). By phenotypic methods, 67.8% were ESBL producers. In the molecular detection of ESBLs, 81.9% were found to be positive for the\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      gene, of which\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>CTX\u2013M<\/jats:sub>\n                      showed 81.8% positivity, followed by\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>TEM<\/jats:sub>\n                      (50%) and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV<\/jats:sub>\n                      (46.9%). In a univariate analysis,\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      gene\u2013positive status was associated with low-density lipoprotein-cholesterol (&gt;100\u2009mg\/dL) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.004, odds ratio 13.4, relative risk 8.65) and triglycerides (&gt;200\u2009mg\/dL) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.003, odds ratio 6.5, relative risk 4.11).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ESBL constitutes a major threat to currently available \u03b2-lactam therapy, leading to complications in DFUs. Aminoglycosides, cephalosporin, and \u03b2-lactam inhibitor drugs would probably be more appropriate empirical agents after establishing the patient's history of previous antibiotic use. The detection of ESBL should be done on a routine basis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2011.0197","type":"journal-article","created":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T14:45:02Z","timestamp":1325861102000},"page":"315-324","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Study of Plasmid-Mediated Extended-Spectrum \u03b2-Lactamase-Producing Strains of Enterobacteriaceae, Isolated from Diabetic Foot Infections in a North Indian Tertiary-Care Hospital"],"prefix":"10.1177","volume":"14","author":[{"given":"Mohammad","family":"Zubair","sequence":"first","affiliation":[{"name":"Aligarh Muslim University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abida","family":"Malik","sequence":"additional","affiliation":[{"name":"Aligarh Muslim University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Aligarh Muslim University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,4,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2006.11.013"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2010.10.003"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhin.2000.0903"},{"key":"e_1_3_3_6_2","first-page":"533","article-title":"Prevalence of mixed infections in the diabetic pedal wound: a retrospective review of 112 infections","volume":"85","author":"Amstrong DG","year":"1995","unstructured":"Amstrong DG, , Liswood PJ, , Todd WF. 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