{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:15:45Z","timestamp":1788545745691,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Diabetes prevalence continues to increase worldwide, which has led to a rising incidence of diabetes-related foot infections (DFIs). There is significant local variation in the microbiology of DFIs, and Pseudomonas spp. is suggested to be more prevalent in subtropical climates. The aim of this study was to investigate the local microbiological findings in patients admitted to the hospital with DFIs. This retrospective study analysed data from all adult patients diagnosed with diabetes and admitted to the hospital for the treatment of a DFI between 1 January 2021 and 31 December 2022. Both superficial wound swabs and tissue cultures were included. The Infectious Diseases Society of America classification system was used to categorise the severity of the DFI. Patient characteristics and demographics were analysed using descriptive statistics. One hundred fifty-one episodes of care were included. Most of the DFIs were classified as moderate infections 101\/151 (67%). The most commonly isolated microorganism was Staphylococcus aureus (33%) followed by normal skin flora (11%) and \u03b2-haemolytic streptococci (7%). P. aeruginosa was isolated more commonly in those with chronic DFIs (10%) compared to those with acute DFIs (2%). Despite the frequent identification of S. aureus, 83% of patients received an antipseudomonal antibiotic. The introduction of multidisciplinary DFI rounds should be considered.<\/jats:p>","DOI":"10.3390\/antibiotics13070594","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T12:18:31Z","timestamp":1719404311000},"page":"594","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Staphylococcus aureus Is the Predominant Pathogen in Hospitalised Patients with Diabetes-Related Foot Infections: An Australian Perspective"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4895-1538","authenticated-orcid":false,"given":"Kate E.","family":"Morton","sequence":"first","affiliation":[{"name":"Pharmacy Department, Lismore Base Hospital, Lismore, NSW 2480, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah H.","family":"Coghill","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Lismore Base Hospital, Lismore, NSW 2480, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s13047-022-00545-4","article-title":"Australian guideline on management of diabetes-related foot infection: Part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease","volume":"15","author":"Commons","year":"2022","journal-title":"J. Foot Ankle Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"485","DOI":"10.5694\/mja2.52136","article-title":"Australian evidence-based guidelines for the prevention and management of diabetes-related foot disease: A guideline summary","volume":"219","author":"Lazzarini","year":"2023","journal-title":"Med. J. Aust."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Macdonald, K.E., Boeckh, S., Stacey, H.J., and Jones, J.D. (2021). The microbiology of diabetic foot infections: A meta-analysis. BMC. Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06516-7"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciad255","article-title":"Evaluation and Management of Diabetes-related Foot Infections","volume":"77","author":"Armstrong","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e3687","DOI":"10.1002\/dmrr.3687","article-title":"IWGDF\/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF\/IDSA 2023)","volume":"40","author":"Senneville","year":"2023","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1016\/j.jvs.2019.08.244","article-title":"A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers","volume":"71","author":"Musuuza","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_7","unstructured":"Bureau of Meteorology (2024, January 08). Climate Classification Maps: Australian Government, Available online: http:\/\/www.bom.gov.au\/climate\/maps\/averages\/climate-classification\/?maptype=kpngrp."},{"key":"ref_8","unstructured":"(2023, December 12). Diabetic Foot Infection. Therapeutic Guidelines Limited. Available online: https:\/\/tgldcdp.tg.org.au\/viewTopic?etgAccess=true&guidelinePage=Antibiotic&topicfile=diabetic-foot-infection."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.diabres.2015.09.016","article-title":"High burden of diabetic foot infections in the top end of Australia: An emerging health crisis (DEFINE study)","volume":"110","author":"Commons","year":"2015","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"ofac297","DOI":"10.1093\/ofid\/ofac297","article-title":"Prevalence and Predictors of Pseudomonas aeruginosa Among Hospitalized Patients With Diabetic Foot Infections","volume":"9","author":"Veve","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5152\/kd.2017.05","article-title":"The Distribution of Causative Microorganisms in Diabetic Foot Infection: Has There Been Any Alterations?","volume":"30","author":"Ertugrul","year":"2017","journal-title":"Klimik Dergisi\/Klimik J."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lee, J., Mashayamombe, M., Walsh, T.P., Kuang, B.K.P., Pena, G.N., Vreugde, S., Cooksley, C., Carda-Dieguez, M., Mira, A., and Jesudason, D. (2023). The bacteriology of diabetic foot ulcers and infections and incidence of Staphylococcus aureus Small Colony Variants. J. Med. Microbiol., 72.","DOI":"10.1099\/jmm.0.001716"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s00592-019-01301-0","article-title":"The prevalence of methicillin-resistant Staphylococcus aureus among diabetic patients: A meta-analysis","volume":"56","author":"Stacey","year":"2019","journal-title":"Acta. Diabetol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e019437","DOI":"10.1136\/bmjopen-2017-019437","article-title":"CODIFI (Concordance in Diabetic Foot Ulcer Infection): A cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England","volume":"8","author":"Nelson","year":"2018","journal-title":"BMJ Open"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.diabres.2011.07.017","article-title":"Microbiology at first visit of moderate-to-severe diabetic foot infection with antimicrobial activity and a survey of quinolone monotherapy","volume":"94","author":"Tascini","year":"2011","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s00125-010-1893-7","article-title":"Changing microbiological profile of pathogenic bacteria in diabetic foot infections: Time for a rethink on which empirical therapy to choose?","volume":"54","author":"Ramakant","year":"2011","journal-title":"Diabetologia"},{"key":"ref_17","first-page":"1","article-title":"Surveillance on multi drug resistant organism (MDRO) associated with diabetic foot ulcers in pondicherry","volume":"5","author":"Sasikala","year":"2007","journal-title":"Internet J. Microbiol."},{"key":"ref_18","first-page":"e29770","article-title":"Microbial Profile and Antimicrobial Susceptibility Pattern in Diabetic Foot Ulcer Patients Attending a Tertiary Care Hospital","volume":"14","author":"Ahmad","year":"2022","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1038\/s41597-023-02549-6","article-title":"High-resolution (1 km) Koppen-Geiger maps for 1901\u20132099 based on constrained CMIP6 projections","volume":"10","author":"Beck","year":"2023","journal-title":"Sci. Data"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1165\/rcmb.2017-0321TR","article-title":"Pseudomonas aeruginosa Biofilms: Host Response and Clinical Implications in Lung Infections","volume":"58","author":"Maurice","year":"2018","journal-title":"Am. J. Respir. Cell. Mol. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Diban, F., Di Lodovico, S., Di Fermo, P., D\u2019Ercole, S., D\u2019Arcangelo, S., Di Giulio, M., and Cellini, L. (2023). Biofilms in Chronic Wound Infections: Innovative Antimicrobial Approaches Using the In Vitro Lubbock Chronic Wound Biofilm Model. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24021004"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Shumba, P., Mairpady Shambat, S., and Siemens, N. (2019). The Role of Streptococcal and Staphylococcal Exotoxins and Proteases in Human Necrotizing Soft Tissue Infections. Toxins, 11.","DOI":"10.3390\/toxins11060332"},{"key":"ref_23","unstructured":"(2023). Soft Tissue Infections Following Water Exposure, Wolters Kluwer. Available online: https:\/\/www.uptodate.com.acs.hcn.com.au\/contents\/soft-tissue-infections-following-water-exposure?search=soft%20tissue%20infection%20following%20water%20exposure&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2044943829."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"22","DOI":"10.25270\/wmp.2021.7.2230","article-title":"Lower limb amputation rates in patients with diabetes and an infected foot ulcer: A prospective observational study","volume":"67","author":"Chaudhary","year":"2021","journal-title":"Wound Manag. Prev."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Tan, T.W., Shih, C.D., Concha-Moore, K.C., Diri, M.M., Hu, B., Marrero, D., Zhou, W., and Armstrong, D.G. (2019). Disparities in outcomes of patients admitted with diabetic foot infections. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0215532"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e00059","DOI":"10.1002\/edm2.59","article-title":"Stopping antibiotics after surgical amputation in diabetic foot and ankle infections\u2014A daily practice cohort","volume":"2","author":"Rossel","year":"2018","journal-title":"Endocrinol. Diabetes Metab. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1093\/cid\/ciad720","article-title":"Utility of proximal bone cultures in diabetes-related foot infections","volume":"78","author":"Khan","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/QCO.0000000000000530","article-title":"Principles and practice of antibiotic stewardship in the management of diabetic foot infections","volume":"32","author":"Berli","year":"2019","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.1017\/ash.2023.123","article-title":"Impact of a syndrome-specific antibiotic stewardship intervention on antipseudomonal antibiotic use in inpatient diabetic foot infection management","volume":"3","author":"McCreery","year":"2023","journal-title":"Antimicrob. Steward. Healthc. Epidemiol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/7\/594\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:05:07Z","timestamp":1760108707000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/7\/594"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,26]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["antibiotics13070594"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13070594","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,26]]}}}