1015_Peters.pdf

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1、IDSA/IWGDF Infection GuidelinesDr.EJG Peters Internist Infectious Diseases and Acute MedicineSpecialistConflicts of Interest No relevant financial disclosures Member guideline committee diabetic foot International Working Group Diabetic Foot Infectious Diseases Society of America Dutch diabetic foot

2、 guidelines Wound Healing Society Wound Healing Foundation Research funding Senior Research Fellow Grant:Dutch Diabetes Research FoundationGoals and take home message Infection is a clinical diagnosis First line diagnostics in osteomyelitis:lab,Xray,probe-to-bone Apply proper culture techniques Know

3、 your local pathogens Not much proof for topical antimicrobials Do not overuse antimicrobials Consider non-antimicrobial therapiesric SennevilleZaina AlbalawiSuzanne van AstenZulfiqarali AbbasGeneve AllisonJavier Argon-SanchezJohn EmbilLarry LaveryMajdi AlhasanOrhan OzIlker UkayVilma Urbanic-RovanZh

4、ang-Rong XuEdgar Peterswww.iwgdfguidelines.orgDiagnosisInfection=clinical diagnosisIWGDF Senneville Diabet Metab Res Rev 2023/Schaper DMRR 2004IDSA Lipsky Clin Infect Dis 2012Infection grade 1IWGDF IDSA DFI classificationNone IWGDF Senneville Diabet Metab Res Rev 2023/Schaper DMRR 2004IDSA Lipsky Cl

5、in Infect Dis 2012Infection grade 2Skin two signs or symptomsLocal swelling or indurationErythema 0.5-2 cm around ulcerPainHeathPurulent dischargeNB:no other explanation than infectionInfection grade 3Erythema 2 cm plus one of the following:Local swelling or indurationPainHeathPurulent discharge OR

6、Infection deeperthan skin Abscess Osteomyelitis Septic arthritis Necrotising soft tissue infectionwith osteomyelitiswithout osteomyelitis with osteomyelitiswithout osteomyelitis Infection grade 3Infection grade 4Every foot infection with SIRS(sepsis 2 criteria)Two or more of the followingTemperature