{"id":4606,"date":"2020-05-05T20:29:37","date_gmt":"2020-05-05T20:29:37","guid":{"rendered":"https:\/\/wordpress-theme.spider-themes.net\/docly\/?post_type=docs&#038;p=4606"},"modified":"2026-01-26T12:27:36","modified_gmt":"2026-01-26T12:27:36","slug":"footnote-2-columns","status":"publish","type":"docs","link":"https:\/\/sahelib.atatec-design.com\/index.php\/docs\/docly-documentation\/footnotes\/footnote-2-columns\/","title":{"rendered":"\u00c9cologie et diagnostic microbiologique des ost\u00e9ites du pied diab\u00e9tique"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Le pr\u00e9l\u00e8vement bact\u00e9riologique<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Le pr\u00e9l\u00e8vement bact\u00e9riologique est une \u00e9tape essentielle pour identifier les germes impliqu\u00e9s dans l\u2019infection et orienter le traitement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Les pr\u00e9l\u00e8vements ne sont indiqu\u00e9s qu\u2019en pr\u00e9sence de signes cliniques d\u2019infection (grades 3 et 4 selon la classification IWGDF) et doivent \u00eatre r\u00e9alis\u00e9s dans des conditions optimales pour \u00e9viter les contaminations.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Le d\u00e9bridement (\u00e0 l\u2019aide d\u2019une curette ou d\u2019un scalpel st\u00e9rile au lit du malade ou r\u00e9alis\u00e9 au bloc op\u00e9ratoire) est une \u00e9tape pr\u00e9alable indispensable<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">La biopsie osseuse<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">La biopsie osseuse (r\u00e9alis\u00e9e par un geste chirurgical ou par ponction percutan\u00e9e radio- ou \u00e9choguid\u00e9e) est la m\u00e9thode de pr\u00e9l\u00e8vement de r\u00e9f\u00e9rence pour le diagnostic microbiologique de l\u2019ost\u00e9ite aigu\u00eb chez les patients diab\u00e9tiques (<em>figure 1<\/em>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Les pr\u00e9l\u00e8vements r\u00e9alis\u00e9s doivent \u00eatre achemin\u00e9s au laboratoire dans un milieu de transport appropri\u00e9 afin de pr\u00e9server la viabilit\u00e9 des germes jusqu\u2019au traitement au laboratoire.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Des h\u00e9mocultures a\u00e9robies et ana\u00e9robies seront r\u00e9alis\u00e9es en cas de sepsis<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Antibioth\u00e9rapie des infections du pied diab\u00e9tique<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dans l\u2019attente des r\u00e9sultats microbiologiques, le choix de l\u2019antibioth\u00e9rapie est d\u00e9termin\u00e9 par la situation clinique et l\u2019\u00e9pid\u00e9miologie microbienne locale.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">L\u2019antibioth\u00e9rapie empirique doit assurer la couverture de&nbsp;<em>S. aureus<\/em>, pathog\u00e8ne le plus fr\u00e9quent au cours de ces infections (<em>tableau 3<\/em>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Lorsque les cultures montrent la pr\u00e9sence de germes multiples, il est recommand\u00e9 de ne traiter que le pathog\u00e8ne qui semble le plus susceptible d\u2019\u00eatre \u00e0 l\u2019origine de l\u2019infection.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">La prise en charge des ost\u00e9ites des pieds chez les patients diab\u00e9tiques demeure tr\u00e8s compliqu\u00e9e. Le diagnostic repose sur les signes cliniques, l\u2019imagerie et la biopsie osseuse, la collaboration clinico-biologique \u00e9tant d\u2019une importance capitale dans cette prise en charge.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D\u00e9claration de liens d\u2019int\u00e9r\u00eats : l\u2019autrice d\u00e9clare ne pas avoir de liens d\u2019int\u00e9r\u00eats. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">r\u00e9f\u00e9rences\u00a0(2)<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>BonnetE.\u00a0<em>et al.<\/em><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S266699192300194X\">Clinical practice recommendations for infectious disease management of diabetic foot infection (DFI) &#8211; 2023 SPILF<\/a>Infect Dis Now.(2024)<\/li>\n\n\n\n<li>LecubeA.\u00a0<em>et al.<\/em>Phagocytic activity is impaired in type 2 diabetes mellitus and increases after metabolic improvementPLoS One.(2011)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Le pr\u00e9l\u00e8vement bact\u00e9riologique Le pr\u00e9l\u00e8vement bact\u00e9riologique est une \u00e9tape essentielle pour identifier les germes impliqu\u00e9s dans l\u2019infection et orienter le traitement. Les pr\u00e9l\u00e8vements ne sont indiqu\u00e9s qu\u2019en pr\u00e9sence de signes cliniques d\u2019infection (grades 3 et 4 selon la classification IWGDF) et doivent \u00eatre r\u00e9alis\u00e9s dans des conditions optimales pour \u00e9viter les contaminations. Le d\u00e9bridement (\u00e0 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":4604,"menu_order":16,"comment_status":"open","ping_status":"closed","template":"","doc_tag":[],"class_list":["post-4606","docs","type-docs","status-publish","hentry","no-post-thumbnail"],"acf":[],"_links":{"self":[{"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/docs\/4606","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/docs"}],"about":[{"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/types\/docs"}],"author":[{"embeddable":true,"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/comments?post=4606"}],"version-history":[{"count":5,"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/docs\/4606\/revisions"}],"predecessor-version":[{"id":6486,"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/docs\/4606\/revisions\/6486"}],"up":[{"embeddable":true,"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/docs\/4604"}],"wp:attachment":[{"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/media?parent=4606"}],"wp:term":[{"taxonomy":"doc_tag","embeddable":true,"href":"https:\/\/sahelib.atatec-design.com\/index.php\/wp-json\/wp\/v2\/doc_tag?post=4606"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}