Dörr Stefan, Holland-Letz Ann-Kathrin, Weisser Gregor, Chatzitomaris Apostolos, Lobmann Ralf
Stuttgart General Hospital, Stuttgart, Germany.
Int J Low Extrem Wounds. 2023 Mar;22(1):63-71. doi: 10.1177/1534734621992290. Epub 2021 Mar 20.
A diabetic foot infection (DFI) contributes to high mortality and morbidity in diabetics due to its often rapid progressive and intricately treatable infection. DFIs are usually a polymicrobial infection and characterizing the entire bacterial load is still challenging. Prompt and effective treatment of DFI is nevertheless mandatory to safe limbs and lives. It is therefore crucial to know the local pathogen spectrum and its antibiotic susceptibility.
For a 12-month period, we investigated 353 individuals with infected diabetic foot ulcer, their bacterial diversity, and antimicrobial susceptibility at fist-time visit in a Diabetic Foot Care Center in southern Germany.
Cultures yielded 888 species, most of them gram-positive cocci (primary ). The gram-negative sector was mainly formed by and . Because the prevalence of multiresistant species was surprisingly low (0.9% of isolated strains), we suggest penicillins with β-lactamase inhibitor in case of gram-positive-dominated infection or piperacillin/tazobactam or rather carbapenems with equal efficacy when gram-negative species are involved.
糖尿病足感染（DFI）因其通常进展迅速且治疗复杂，导致糖尿病患者的死亡率和发病率居高不下。DFIs通常是一种多微生物感染，确定整个细菌负荷仍具有挑战性。然而，及时有效地治疗DFI对于保全肢体和生命至关重要。因此，了解局部病原体谱及其抗生素敏感性至关重要。
在德国南部的一个糖尿病足护理中心，我们对353例首次就诊的糖尿病足溃疡感染患者进行了为期12个月的调查，研究了他们的细菌多样性和抗菌药物敏感性。
培养出888种菌种，其中大多数为革兰氏阳性球菌（主要是）。革兰氏阴性菌主要由和组成。由于多重耐药菌种的患病率出奇地低（分离菌株的0.9%），我们建议在革兰氏阳性菌为主的感染情况下使用含β-内酰胺酶抑制剂的青霉素，或在涉及革兰氏阴性菌时使用哌拉西林/他唑巴坦或疗效相当的碳青霉烯类药物。
