Abstract
This work presents a protocol to prevent the transmission of multidrug-resistant infections. We focus on the Diabetic Foot Unit Podiatry Clinic Area attached to the University of Seville in particular. The most common complication for patients with diabetes is leg ulcers. Together with neuropathy, vasculopathy, and immunological response disorder, these individuals have a high predisposition to developing infections. Staphylococcus aureus is a highly prevalent microorganism in humans which, at times, may act as a pathogen. Due mainly to indiscriminate abuse of antibiotics, the methicillin-resistant strain known by its initials as MRSA is the most extended nosocomial infection globally and is a severe community and hospital healthcare problem. This paper describes compliance with new general recommendations on cleaning, hygiene, and decontamination, in addition to implementation of this specific protocol, after detection of cross infection (healthcare-related infection) in the studied unit in two patients with MRSA-infected ulcers. After an in-depth bibliographical review, strict hand hygiene measures and use of non-sterile gloves were used when treating all patients with a diabetic foot. Finally, we reflect on the need to educate healthcare personnel to guarantee correct prescription of selected antibiotics. The role of the podiatrist in the multidisciplinary team is highlighted not only in terms of management and treatment of lesions in diabetic patients, but also as a healthcare agent for the detection and prevention of MRSA together with other multidrug-resistant infections.
Highlights
Diabetes mellitus (DM) is a combination of metabolic disorders characterized by hyperglycemia where insulin is incapable of functioning and/or the amount of segregated insulin is insufficient to obtain the necessary hypoglycemic effect
Diabetic foot syndrome is defined by the World Health Organization (WHO) as “ulceration, infection, and/or gangrene of the foot associated with peripheral neuropathy in different degrees of peripheral arterial disease and the result of the complex interaction of different factors” [2]
The Podiatry Clinic Area implemented a multimodal strategy to improve the hand hygiene compliance in parallel. This intervention included four components recommended by the WHO with adaptations for this context: system change, education, reminders in the workplace (“how to handwash” and “my five moments for hand hygiene” posters), and safety climate [18]
Summary
Diabetes mellitus (DM) is a combination of metabolic disorders characterized by hyperglycemia where insulin is incapable of functioning and/or the amount of segregated insulin is insufficient to obtain the necessary hypoglycemic effect. Hygiene and disinfection guidelines are essential for prevention in the hospital and healthcare center settings To avoid these infections, a series of standard precautions is necessary for all patients, and some specific regulated procedures must be added in those patients diagnosed with MRSA in general as well as those with. The Diabetic Foot Unit of the Podiatry Clinic Area attached to the University of Seville has a care, research, and teaching purpose, because it sees patients, performs various research lines, and is a location for work experience for students completing a graduate degree in podiatry. This unit provides diabetes mellitus patients with full preventive care and treatment.
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