{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:03:29Z","timestamp":1774627409563,"version":"3.50.1"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The prior Medical Director of Geneva University Hospitals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>In diabetic foot infections (DFI), the clinical virulence of skin commensals are generally presumed to be low. In this single-center study, we divided the wound isolates into two groups: skin commensals (coagulase-negative staphylococci, micrococci, corynebacteria, cutibacteria) and pathogenic pathogens, and followed the patients for \u2265 6 months. In this retrospective study among 1018 DFI episodes (392 [39%] with osteomyelitis), we identified skin commensals as the sole culture isolates (without accompanying pathogenic pathogens) in 54 cases (5%). After treatment (antibiotic therapy [median of 20 days], hyperbaric oxygen in 98 cases [10%]), 251 episodes (25%) were clinical failures. Group comparisons between those growing only skin commensals and controls found no difference in clinical failure (17% vs. 24 %, p = 0.23) or microbiological recurrence (11% vs. 17 %, p = 0.23). The skin commensals were mostly treated with non-beta-lactam oral antibiotics. In multivariate logistic regression analysis, the isolation of only skin commensals was not associated with failure (odds ratio 0.4, 95% confidence interval 0.1\u20133.8). Clinicians might wish to consider these isolates as potential pathogens when selecting a targeted antibiotic regimen, which may also be based on oral non-beta-lactam antibiotic agents effective against the corresponding skin pathogens.<\/jats:p>","DOI":"10.3390\/antibiotics12020316","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T02:35:10Z","timestamp":1675391710000},"page":"316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Influence of Skin Commensals on Therapeutic Outcomes of Surgically Debrided Diabetic Foot Infections\u2014A Large Retrospective Comparative Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Ilker","family":"U\u00e7kay","sequence":"first","affiliation":[{"name":"Infectiology, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland"},{"name":"Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Lebowitz","sequence":"additional","affiliation":[{"name":"Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland"},{"name":"Service of Internal Medicine, Clinique des Grangettes, Hirslanden, 1224 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Kressmann","sequence":"additional","affiliation":[{"name":"Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin A.","family":"Lipsky","sequence":"additional","affiliation":[{"name":"Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland"},{"name":"Department of Medicine, University of Washington, Seattle, WA 98195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8089-4785","authenticated-orcid":false,"given":"Karim","family":"Gariani","sequence":"additional","affiliation":[{"name":"Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland"},{"name":"Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Geneva University Hospitals, 1205 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/dom.12190","article-title":"Diabetic foot infections: State-of-the-art","volume":"16","author":"Gariani","year":"2014","journal-title":"Diabetes Obes. 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