Abstract
Diabetes mellitus has become a major global health issue. Currently, the use of antibiotics remains the best foundational strategy in the control of diabetic foot infections. However, the lack of accurate identification of pathogens and the empirical use of antibiotics at early stages of infection represents a non-targeted treatment approach with a poor curative effect that may increase the of bacterial drug resistance. Therefore, the timely identification of drug resistant bacteria is the key to increasing the efficacy of treatments for diabetic foot infections. The traditional identification method is based on bacterial morphology, cell physiology, and biochemistry. Despite the simplicity and low costs associated with this method, it is time-consuming and has limited clinical value, which delays early diagnosis and treatment. In the recent years, MALDI-TOF MS has emerged as a promising new technology in the field of clinical microbial identification. In this study, we developed a strategy for the identification of drug resistance in the diagnosis of diabetic foot infections using a combination of macro-proteomics and MALDI MS analysis. The macro-proteomics result was utilized to determine the differential proteins in the resistance group and the corresponding peptide fragments were used as the finger print in a MALDI MS analysis. This strategy was successfully used in the research of drug resistance in patients with diabetic foot infections and achieved several biomarkers that could be used as a finger print for 4 different drugs, including ceftazidime, piperacillin, levofloxacin, and tetracycline. This method can quickly confirm the drug resistance of clinical diabetic foot infections, which can help aid in the early treatment of patients.
Highlights
Diabetes mellitus has become a major global health issue affecting approximately 9.3% of the population worldwide, and is expected to increase by 25% by 2030 (Sinclair et al, 2020)
In the case for bacillus, ceftazidime and piperacillin were chosen as the test drugs, and levofloxacin and tetracycline were chosen for staphylococcus aureus
We have developed a strategy for the identification of drug resistance in the diagnosis of diabetic foot
Summary
Diabetes mellitus has become a major global health issue affecting approximately 9.3% of the population worldwide, and is expected to increase by 25% by 2030 (Sinclair et al, 2020). Of all the complications of diabetes mellitus, diabetic pedopathy poses the most severe risks, and may result in a shortened life expectancy and a dramatic decline in the quality of life (Lavery et al, 2016). Due to the lack of accurate identification of the pathogens, the empirical use of antibiotics at the early stages of infection represents a non-targeted treatment approach with a poor curative effect, and may result in bacterial drug resistance (Munita and Arias, 2016). The ineffective use of antibiotics will hinder wound healing in patients with diabetic foot infections, and increase the length of stay in hospitals as well as hospital costs. Timely identification of bacteria and drug resistance is the key in the appropriate treatment of diabetic foot infections (Caruso et al, 2021)
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