title: Infections with Pseudomonas aeruginosa in Charcot arthropathy of the foot.
abstract: BACKGROUND
  Patients with Charcot arthropathy present a high risk for ulcers with secondary bone infection. Infections with Pseudomonas aeruginosa represent a severe threat to the patients. We hypothesized that infections with P aeruginosa result in a longer stay in hospital and more operations than infections with other bacteria.
  
  
  METHODS
  All patients who underwent surgery for Charcot arthropathy of the feet between 1996 and 2006 (n = 205) in our clinic were included. The duration of hospitalization and number of surgeries for infections due to methicillin-resistant Staphylococcus aureus (MRSA) versus P aeruginosa were compared to infections with other bacteria. All patients were scanned for MRSA and were isolated when tested positive and treated according to a defined algorithm.
  
  
  RESULTS
  Seventy-nine intraoperative samples exhibited bacterial growth: 12 cases of MRSA, 14 cases of P aeruginosa, and 53 case of other bacteria. Patients with deep infections due to P aeruginosa stayed significantly longer in the hospital (52 vs 35 days, P < .041) and needed significantly more surgery (1.71 vs 1.28 surgeries, P < .027). There was no significant difference between patients with MRSA infections and those without MRSA or P aeruginosa.
  
  
  CONCLUSIONS
  Infections with P aeruginosa resulted in more surgeries and a longer stay in the hospital. Early debridement is the basic treatment. A specific algorithm for isolation and operative and antibiotic treatment for P aeruginosa infections is proposed similar to an algorithm for MRSA that has been shown to be successful.
  
  
  METHODS
  Level IV, retrospective case Series.
authors: Universitätsklinikum Münster, Muenster, Germany. ulrich_ilgner@web.de
authors: Ulrich
authors: U
authors: Illgner
authors: Andreas
authors: A
authors: Uekoetter
authors: Sabrina
authors: S
authors: Runge
authors: Hans Henning
authors: HH
authors: Wetz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001177:Arthropathy, Neurogenic / Q000150:complications*; D003646:Debridement; D048909:Diabetes Complications; D005260:Female; D005534:Foot Diseases / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010019:Osteomyelitis / Q000382:microbiology* / Q000628:therapy; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000628:therapy*; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents