Abstract：
SUMMARYDiabetic foot infections (DFI) are a public health problem worldwide. DFI are polymicrobial, biofilm-associated infections involving complex bacterial communities organized in functional equivalent pathogroups, all including anaerobes. Indeed, multiple pathophysiological factors favor the growth of anaerobes in this context. However, the prevalence, role, and contribution of anaerobes in wound evolution remain poorly characterized due to their challenging detection. Studies based on culture reviewed herein showed a weighted average of 17% of patients with anaerobes. Comparatively, the weighted average of patients with anaerobes identified by 16S rRNA gene sequencing was 83.8%. Culture largely underestimated not only the presence but also the diversity of anaerobes compared with cultivation-independent approaches but both methods showed that anaerobic Gram-negative bacilli and Gram-positive cocci were the most commonly identified in DFI. Anaerobes were more present in deeper lesions, and their detection was associated with fever, malodorous lesions, and ulcer depth and duration. More specifically, initial abundance of Peptoniphilus spp. was associated with ulcer-impaired healing, Fusobacterium spp. detection was significantly correlated with the duration of DFI, and the presence of Bacteroides spp. was significantly associated with amputation. Antimicrobial resistance of anaerobes in DFI remains slightly studied and warrants more consideration in the context of increasing resistance of the most frequently identified anaerobes in DFI. The high rate of patients with DFI-involving anaerobes, the increased knowledge on the species identified, their virulence factors, and their potential role in wound evolution support recommendations combining debridement and antibiotic therapy effective on anaerobes in moderate and severe DFI.
摘要：
糖尿病足部感染(DFI)是全球范围内的公共卫生问题。DFI是多微生物的，生物膜相关感染涉及在功能等效病理组中组织的复杂细菌群落，包括厌氧菌.的确,在这种情况下，多种病理生理因素有利于厌氧菌的生长。然而,患病率,角色,由于具有挑战性的检测，厌氧菌在伤口演变中的贡献仍然缺乏表征。基于本文综述的培养物的研究显示17%的厌氧菌患者的加权平均值。相对而言,通过16SrRNA基因测序鉴定的厌氧菌患者的加权平均值为83.8%.与独立培养的方法相比，培养不仅大大低估了厌氧菌的存在，而且还低估了厌氧菌的多样性，但两种方法都表明厌氧革兰氏阴性杆菌和革兰氏阳性球菌在DFI中最常见。在较深的病变中存在更多的厌氧菌，他们的检测与发烧有关，恶臭病变，溃疡深度和持续时间。更具体地说,Peptoniphilusspp的初始丰度。与溃疡受损的愈合有关，梭杆菌属。检测与DFI的持续时间显着相关，以及拟杆菌的存在。与截肢显著相关。DFI中厌氧菌的抗菌素耐药性仍有少量研究，在DFI中最常见的厌氧菌的耐药性增加的背景下，值得更多考虑。DFI累及厌氧菌的患者比例较高，对确定的物种的了解增加，它们的毒力因子，以及它们在伤口演变中的潜在作用支持联合清创和抗生素治疗对中度和重度DFI厌氧菌有效的建议。
