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Multidrug resistant organism predicts ulcer recurrence following surgical management of diabetic foot osteomyelitis
dc.contributor.authorSchmidt, Brian M.
dc.contributor.authorYe, Wen
dc.contributor.authorZhou, Shiwei
dc.date.accessioned2021-01-05T18:48:50Z
dc.date.availableWITHHELD_12_MONTHS
dc.date.available2021-01-05T18:48:50Z
dc.date.issued2020-12
dc.identifier.citationSchmidt, Brian M.; Ye, Wen; Zhou, Shiwei (2020). "Multidrug resistant organism predicts ulcer recurrence following surgical management of diabetic foot osteomyelitis." International Wound Journal 17(6): 1634-1641.
dc.identifier.issn1742-4801
dc.identifier.issn1742-481X
dc.identifier.urihttps://hdl.handle.net/2027.42/163950
dc.description.abstractDiabetic foot ulcers commonly precede diabetic foot osteomyelitis (DFO) and once the latter occurs, surgical management is often performed. The presence of osteomyelitis is an independent risk factor for the development of re‐ulceration. We investigated the relationship between causative organisms in osteomyelitis and 1‐year diabetic foot outcomes (re‐ulceration, amputation, and death) following surgical management in an observational cohort of 223 patients. Univariate and multivariate analyses were performed for available demographic, clinical, and laboratory data. In addition, random forest plots were used to identify microbiologic predictors of 1‐year outcomes. Patients with osteomyelitis managed surgically were younger and exhibited more painful peripheral neuropathy than outpatients with diabetes alone (both P < .0001). Osteomyelitis proximal margin cultures were diverse, at times polymicrobial, and included multidrug‐resistant organisms in 13.9% of the cohort. In patients who underwent surgery, 44.5% experienced a re‐ulceration on the same foot within 12 months of surgery. The presence of multidrug‐resistant organisms on proximal bone culture was found to be a significant predictor of diabetic foot ulcer recurrence in univariate modelling (P < .001) and importance rankings. This is the first study to use prediction modelling to identify a relationship between multidrug‐resistant organisms and diabetic foot ulcer recurrence following DFO.
dc.publisherBlackwell Publishing Ltd
dc.publisherWiley Periodicals, Inc.
dc.subject.othermultidrug‐resistant organisms
dc.subject.otherulcer recurrence
dc.subject.otherdiabetic foot ulcer
dc.subject.otherdiabetic foot osteomyelitis
dc.subject.otheramputation
dc.titleMultidrug resistant organism predicts ulcer recurrence following surgical management of diabetic foot osteomyelitis
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelMedicine (General)
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/163950/1/iwj13439_am.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/163950/2/iwj13439.pdf
dc.identifier.doi10.1111/iwj.13439
dc.identifier.sourceInternational Wound Journal
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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