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Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis: a retrospective exploratory study

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Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis : a retrospective exploratory study. / Fitzgerald, Pauline; Siddle, Heidi J; Backhouse, Michael R; Nelson, E Andrea.

In: Journal of Foot and Ankle Research, Vol. 8, No. 38, 16.08.2015, p. 38.

Research output: Contribution to journalArticle

Harvard

Fitzgerald, P, Siddle, HJ, Backhouse, MR & Nelson, EA 2015, 'Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis: a retrospective exploratory study', Journal of Foot and Ankle Research, vol. 8, no. 38, pp. 38. https://doi.org/10.1186/s13047-015-0099-0

APA

Fitzgerald, P., Siddle, H. J., Backhouse, M. R., & Nelson, E. A. (2015). Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis: a retrospective exploratory study. Journal of Foot and Ankle Research, 8(38), 38. https://doi.org/10.1186/s13047-015-0099-0

Vancouver

Fitzgerald P, Siddle HJ, Backhouse MR, Nelson EA. Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis: a retrospective exploratory study. Journal of Foot and Ankle Research. 2015 Aug 16;8(38):38. https://doi.org/10.1186/s13047-015-0099-0

Author

Fitzgerald, Pauline ; Siddle, Heidi J ; Backhouse, Michael R ; Nelson, E Andrea. / Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis : a retrospective exploratory study. In: Journal of Foot and Ankle Research. 2015 ; Vol. 8, No. 38. pp. 38.

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@article{f989e8473b644714a5bf0088842043be,
title = "Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis: a retrospective exploratory study",
abstract = "BACKGROUND: The prevalence of foot ulcers in patients with rheumatoid arthritis (RA) has been reported at almost 10 {\%}. These foot ulcers often occur at multiple sites and are reoccurring, with the potential risk of infection increased due to RA diagnosis and disease modifying medications. The objective of this study was to estimate the prevalence of clinical infection in foot-ulcers of patients with RA; describe the microbiological characteristics and investigate risk factors.METHODS: Retrospective clinical data was collected for all patients attending a rheumatology foot ulcer clinic between 1st May 2012 and 1st May 2013: wound swab data was collected from those with clinical infection.RESULTS: Twenty-eight patients with RA and foot-ulcers were identified; eight of these patients had clinical infection and wound swabs taken (29 {\%}). Of these eight patients there were equal men and women, with median age 74 years, and average disease duration 22 years. Cardiovascular disease/peripheral-vascular disease (CVD/PVD) were reported in six patients, diabetes in two patients. Six patients were treated with disease-modifying anti-rheumatic drugs (DMARDs); three were on biologic medications and two on steroids. Five wound swabs cultured skin flora, one staphylococcus aureus, one had no growth after culture; and one was rejected due to labelling error.CONCLUSION: Almost a third of people with RA and foot ulcers attending clinic over one year had clinical infection, however microbiological analysis failed to isolate pathogens in six of seven wound swabs. This may be due to inaccurate diagnosis of ulcer infection or to issues with sampling, collection, transport, analysis or reporting. There was insufficient data to relate risk of clinical infection with risk factors. Further research is required to identify the most appropriate techniques for infection diagnosis, wound sampling and processing.TRIAL REGISTRATION: Ethical approval was obtained from University of Leeds, Faculty of Medicine and Health (Reference number: SHREC/RP/349).",
keywords = "Journal Article",
author = "Pauline Fitzgerald and Siddle, {Heidi J} and Backhouse, {Michael R} and Nelson, {E Andrea}",
year = "2015",
month = "8",
day = "16",
doi = "10.1186/s13047-015-0099-0",
language = "English",
volume = "8",
pages = "38",
journal = "Journal of Foot and Ankle Research",
issn = "1757-1146",
publisher = "BioMed Central Ltd.",
number = "38",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis

T2 - a retrospective exploratory study

AU - Fitzgerald, Pauline

AU - Siddle, Heidi J

AU - Backhouse, Michael R

AU - Nelson, E Andrea

PY - 2015/8/16

Y1 - 2015/8/16

N2 - BACKGROUND: The prevalence of foot ulcers in patients with rheumatoid arthritis (RA) has been reported at almost 10 %. These foot ulcers often occur at multiple sites and are reoccurring, with the potential risk of infection increased due to RA diagnosis and disease modifying medications. The objective of this study was to estimate the prevalence of clinical infection in foot-ulcers of patients with RA; describe the microbiological characteristics and investigate risk factors.METHODS: Retrospective clinical data was collected for all patients attending a rheumatology foot ulcer clinic between 1st May 2012 and 1st May 2013: wound swab data was collected from those with clinical infection.RESULTS: Twenty-eight patients with RA and foot-ulcers were identified; eight of these patients had clinical infection and wound swabs taken (29 %). Of these eight patients there were equal men and women, with median age 74 years, and average disease duration 22 years. Cardiovascular disease/peripheral-vascular disease (CVD/PVD) were reported in six patients, diabetes in two patients. Six patients were treated with disease-modifying anti-rheumatic drugs (DMARDs); three were on biologic medications and two on steroids. Five wound swabs cultured skin flora, one staphylococcus aureus, one had no growth after culture; and one was rejected due to labelling error.CONCLUSION: Almost a third of people with RA and foot ulcers attending clinic over one year had clinical infection, however microbiological analysis failed to isolate pathogens in six of seven wound swabs. This may be due to inaccurate diagnosis of ulcer infection or to issues with sampling, collection, transport, analysis or reporting. There was insufficient data to relate risk of clinical infection with risk factors. Further research is required to identify the most appropriate techniques for infection diagnosis, wound sampling and processing.TRIAL REGISTRATION: Ethical approval was obtained from University of Leeds, Faculty of Medicine and Health (Reference number: SHREC/RP/349).

AB - BACKGROUND: The prevalence of foot ulcers in patients with rheumatoid arthritis (RA) has been reported at almost 10 %. These foot ulcers often occur at multiple sites and are reoccurring, with the potential risk of infection increased due to RA diagnosis and disease modifying medications. The objective of this study was to estimate the prevalence of clinical infection in foot-ulcers of patients with RA; describe the microbiological characteristics and investigate risk factors.METHODS: Retrospective clinical data was collected for all patients attending a rheumatology foot ulcer clinic between 1st May 2012 and 1st May 2013: wound swab data was collected from those with clinical infection.RESULTS: Twenty-eight patients with RA and foot-ulcers were identified; eight of these patients had clinical infection and wound swabs taken (29 %). Of these eight patients there were equal men and women, with median age 74 years, and average disease duration 22 years. Cardiovascular disease/peripheral-vascular disease (CVD/PVD) were reported in six patients, diabetes in two patients. Six patients were treated with disease-modifying anti-rheumatic drugs (DMARDs); three were on biologic medications and two on steroids. Five wound swabs cultured skin flora, one staphylococcus aureus, one had no growth after culture; and one was rejected due to labelling error.CONCLUSION: Almost a third of people with RA and foot ulcers attending clinic over one year had clinical infection, however microbiological analysis failed to isolate pathogens in six of seven wound swabs. This may be due to inaccurate diagnosis of ulcer infection or to issues with sampling, collection, transport, analysis or reporting. There was insufficient data to relate risk of clinical infection with risk factors. Further research is required to identify the most appropriate techniques for infection diagnosis, wound sampling and processing.TRIAL REGISTRATION: Ethical approval was obtained from University of Leeds, Faculty of Medicine and Health (Reference number: SHREC/RP/349).

KW - Journal Article

U2 - 10.1186/s13047-015-0099-0

DO - 10.1186/s13047-015-0099-0

M3 - Article

VL - 8

SP - 38

JO - Journal of Foot and Ankle Research

JF - Journal of Foot and Ankle Research

SN - 1757-1146

IS - 38

ER -