Clinical laboratory · 2024
Risk Factors for Multidrug-Resistant Bacterial Infection in Diabetic Foot Ulcers.
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Chen Tian, Yu Jianhua, Mu Qi, Wu Ruibo, Chang Qi, Ye Jin, Qian Chao
Аннотация
BACKGROUND: This study aimed to analyze the distribution of multidrug-resistant (MDR) organisms (MDROs) in patients with diabetic foot ulcers (DFUs) and to identify risk factors for MDRO infections.
METHODS: Patients hospitalized with DFUs were enrolled, and ulcer swabs were cultured for bacterial identification and antibiotic susceptibility testing. Hematology and blood biochemistry were also assessed.
RESULTS: A total of 228 patients hospitalized with DFUs were enrolled. Out of 150 patients with positive cultures, 123 (82%) were infected with single strains, whereas 27 (18%) had mixed infections. Out of the 177 bacterial strains isolated, 78 (44%) were MDROs. Among the top 5 most common bacteria, coagulase-negative Staphylococcus, Staphylococcus aureus, and Proteus exhibited MDR rates of 92%, 56%, and 55%, respectively. Pseudomonas aeruginosa and Enterobacter cloacae had low MDR rates of 5% and 8%, respectively. Single variable logistic regression analysis showed that neutrophil percent (NEU%), creatinine, C-reactive protein, and fasting plasma glucose (FPG) were risk factors for MDRO infection, whereas hemoglobin and albumin levels were protective factors. Multivariable logistic regression analysis revealed that NEU% and FPG were independent risk factors for MDRO infection.
CONCLUSIONS: A high percentage of the infections in patients with DFUs were caused by MDROs. To reduce MDRO infections in high-risk patients, it is important to use antibiotics rationally, improve patients' FPG levels and nutritional status, and strengthen hospital sterilization processes.
METHODS: Patients hospitalized with DFUs were enrolled, and ulcer swabs were cultured for bacterial identification and antibiotic susceptibility testing. Hematology and blood biochemistry were also assessed.
RESULTS: A total of 228 patients hospitalized with DFUs were enrolled. Out of 150 patients with positive cultures, 123 (82%) were infected with single strains, whereas 27 (18%) had mixed infections. Out of the 177 bacterial strains isolated, 78 (44%) were MDROs. Among the top 5 most common bacteria, coagulase-negative Staphylococcus, Staphylococcus aureus, and Proteus exhibited MDR rates of 92%, 56%, and 55%, respectively. Pseudomonas aeruginosa and Enterobacter cloacae had low MDR rates of 5% and 8%, respectively. Single variable logistic regression analysis showed that neutrophil percent (NEU%), creatinine, C-reactive protein, and fasting plasma glucose (FPG) were risk factors for MDRO infection, whereas hemoglobin and albumin levels were protective factors. Multivariable logistic regression analysis revealed that NEU% and FPG were independent risk factors for MDRO infection.
CONCLUSIONS: A high percentage of the infections in patients with DFUs were caused by MDROs. To reduce MDRO infections in high-risk patients, it is important to use antibiotics rationally, improve patients' FPG levels and nutritional status, and strengthen hospital sterilization processes.