Abstract
Infectious disease is the second leading cause of death among dialysis patients, and the standardized mortality ratio for all infectious diseases was 7.5 (95% confidence interval, 7.3–7.6) in dialysis patients with respect to the general population in Japan. The incidence of sepsis is higher in dialysis patients than that in general population and chronic foot infections can induce sepsis. The control of infection is very important to treat foot ulcers. Bacterial cultures for wound and blood sample must be done before starting antibiotics and we must create the local database about the kinds of bacteria and the sensitivity for antibiotics. It is very important to start the empiric wide-spectrum antibiotics treatment as soon as possible before the detection of bacteria inducing foot infections. We must use an enough amount of antibiotics at beginning the treatment even in dialysis patients. Gram-positive bacteria, especially Methicilin-resistance Staphylococcus aureus and Coagulase-negative staphylococci, for example, Staphylococcus epidermidis are frequently detected. Furthermore, Gram-negative bacteria, such as Pseudomonas aerginosa is often detected in dialysis patients. Nutritional assessment must be done in dialysis patients with chronic foot infection.
