Characterization of Microbial Profiles and Antimicrobial Resistance in Diabetic Foot Ulcers at a Tertiary Care Facility in Northern China.

INTRODUCTION

There are differences in the microbiological and antimicrobial patterns of patients with diabetic foot infections (DFI) in different regions. Understanding the microbiological and antimicrobial patterns of patients with DFI in this region provides a basis for the empirical use of antibiotics in clinical practice.

METHODS

This study retrospectively analyzed the clinical and laboratory characteristics and microbiological and antibacterial patterns of patients with DFI from January 2016 to December 2023.

RESULTS

A total of 697 patients were included, with the majority being male (63.4%), and ages ranging from 50 to 75 years (59.3%). Most had poor blood sugar control (70.3%). Among them, 527 (75.6%) had single microorganism infections, while 170 (24.4%) had multiple microorganism infections. A total of 891 pathogenic strains were isolated, of which 419 (47.0%) were Gram-positive bacteria (GPB), 454 (51.0%) were Gram-negative bacteria (GNB), and 18 (2.0%) were fungi. The most common GPB is Staphylococcus aureus (196, 22.0%), while the most common GNB is Proteus mirabilis (70, 7.9%). GNB infections and multiple microorganism infections were more prevalent than GPB infections and single microorganism infections in Wagner grades 3-4. Patients with GNB infections had higher levels of ESR, WBC, NE, NEUT, PCT, and CRP, while ALB and Hb levels were lower. GPB were highly sensitive to teicoplanin (100%), followed by vancomycin (99.6%) and tigecycline (99.2%); GNB exhibited high sensitivity to sulperazon and amikacin (100%), followed by ertapenem (98.8%) and meropenem (98.6%).

CONCLUSION

The proportion of GNB is greater than that of GPB, primarily found in patients with moderate to severe DFI, who exhibit higher levels of inflammatory markers and more severe infections. However, S. aureus remains the most common microorganism in DFI. When using antibiotics, especially for patients with mild infections, coverage for common GPB, including S. aureus, should be considered, while for patients with moderate to severe infections, coverage should include common GNB.