Résumé
Background: foot infections in persons with diabetes harbor a rich polymicrobial community of aerobic and anaerobic species. Few data are available on the role of anaerobes in these infections.Methods: monocentric retrospective study including all diabetic patients with a foot infection who had amicrobiological sample taken during the period from January 1, 2019 to December 31, 2021 at the CHU de Nîmes. We divided the study population into two groups: those with an infection of aerobic bacteria alone (absence of anaerobes) and those with a mixed infection combining aerobic and anaerobic bacteria (presence of anaerobes). Clinico-biological factors and wound evolution were compared.Results: 302 patients were included in the study. In multivariate analysis, obesity (OR 2.69; p=0.008), insulintreatment (OR 2.04; p=0.05) and polymicrobial sampling (OR 2.86; P<0.001) were significantly associated with thepresence of anaerobic bacteria. Furthermore, the rate of amputation was significantly associated with the presence of anaerobic bacteria in the diabetic foot. However, there was no significant difference between the two groups in the rate of failure or death at 1 year. In subgroup analysis (N=142), in patients who had healed, healing time was significantly longer in the anaerobic-positive group. 42.1% of patients in our study had anaerobic bacteria in their IPD. s was the most represented species (n=28; 17%), followed by bacteroides fragilis (n=18; 10.9%) and Anaerococcus vaginalis (n=13; 7.9%).Conclusion: anaerobic bacteria are major representatives of polymicrobial communities in the diabetic foot and are associated with obesity, insulin therapy, polymicrobial sampling and a higher amputation rate.