Group B Streptococcus-infected diabetic foot ulcers with tenosynovial involvement require “aggressive treatment” by surgeons, according to new research.
The study also found that GBS-infected DFUs are more common in Black patients and those with elevated haemoglobin A1Cs.
GBS is a common pathogen in diabetic foot ulcers, where it has been found to result in higher rates of soft tissue infection and amputation despite appropriate treatment.
A team from the University of Rochester Medical Center, University of Buffalo and Yale School of Medicine set out to investigate the clinical characteristics and prognosis of GBS DFU infections, especially those with tenosynovial involvement.
Data were retrospectively collected from GBS-infected DFU patients who were surgically treated by an orthopaedic foot and ankle surgeon over a four-year period.
Clinical outcome was assessed by recurrent infection and unplanned reoperation(s) within three months following the initial surgery.
The team reported: “In total, 72 patients were treated for GBS-infected DFUs. Intra-operative culture of infected bone identified GBS in 16 patients (22.2 per cent). Significantly more black patients (p=0.017) were afflicted by GBS DFUs.
“Patients with GBS DFUs had higher initial haemoglobin A1C levels (p=0.019), and those with tenosynovial involvement were likely to require reoperation (p=0.036) and had a greater total number of surgeries (p=0.015) than those without.”
They concluded: “GBS-infected DFUs are more common in Black patients and those with elevated haemoglobin A1Cs.
“GBS infections with tenosynovial involvement are particularly destructive and require aggressive treatment by surgeons.”
Read the study in the Journal of Wound Care.
