CODIFI (Concordance in Diabetic Foot Infection): Agreement in reported presence of likely pathogens in swabs and tissue samples from infected diabetic foot ulcers

Aim Wound infection is common in diabetic foot ulcers with potentially life changing sequelae. Targeted treatment of infective organisms requires accurate identification of pathogens to enable refinement of antibiotic protocols to improve outcomes and reduce antibiotic resistance. Wound sampling is routinely conducted using swabs although some guidelines recommend use of tissue samples. To date there is a lack of robust evidence to inform clinical practice regarding sampling technique. This study aimed to evaluate the extent to which results from wound swab and tissue samples taken from the same patient agree with each other; one might report pathogens more than the other, they might both report the same pathogens consistently, or they might disagree with a more complex pattern of disagreement. Here we report agreement and disagreement between the techniques based upon reported presence of likely pathogens.