Department of Endocrinology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Department of Infectious Disease, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Ann Palliat Med. 2021 Dec;10(12):12618-12630. doi: 10.21037/apm-21-3406.
Diabetic foot ulcer (DFU) is one of the main causes of disability and death in diabetic patients, along with the continuous development of relevant research. The purpose of this paper is to study the risk factors of multidrug resistant organisms (MDROs) infection in patients with DFUs by meta-analysis.
We searched the PubMed, EMBASE, Cochrane library, and Web of Science databases for literature related to the risk factors of MDRO infection in patients with DFUs from the date of establishment of the database to September 2021. Duplicate studies were excluded using Endnote X9 software. Stata 15.1 software was used to meta-analyze the data. Random or fixed effects models were used to combine and analyze the odds ratio (OR) and 95% confidence interval (CI) of the included risk factors. Heterogeneity was analyzed by the Q and I2 tests. Egger's linear regression method was used to evaluate the publication bias of the included articles. Sensitivity analysis was used to analyze the source of heterogeneity.
A total of 13 articles were included in the study. Meta-analysis was performed on 15 risk factors. Among them, hospital records before admission (OR =5.18, 95% CI: 1.45-18.51, P=0.011), antibiotic use before admission (OR =2.17, 95% CI: 1.24-3.79, P=0.006), diabetes type (OR =2.44, 95% CI: 1.29-4.64, P=0.006), ulcer type (OR =2.17, 95% CI: 1.06-4.41, P=0.033), ulcer size (OR =2.56, 95% CI: 1.53-4.28, P<0.001), osteomyelitis (OR =3.50, 95% CI: 2.37-5.16, P<0.001), vascular disease (OR =2.37, 95% CI: 1.41-3.99, P=0.001), surgical treatment (OR =4.80, 95% CI: 2.95-7.83, P<0.001), and these meta-analysis results were statistically different and could be considered as risk factors for MDRO infection.
The risk factors of MDRO infection in DFU patients include hospitalization records before admission, antibiotic use before admission, type of diabetes, type of ulcer, size of ulcer, osteomyelitis, vascular lesions, and surgical treatment. This study contributes to the ability of the population of DFU patients infected with MDROs to receive timely treatment at an early stage and delay disease development.
糖尿病足溃疡（DFU）是糖尿病患者致残和死亡的主要原因之一，随着相关研究的不断发展。本文旨在通过荟萃分析研究 DFU 患者中多重耐药菌（MDROs）感染的危险因素。
我们检索了 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库中从数据库建立到 2021 年 9 月与 DFU 患者 MDRO 感染相关的文献。使用 Endnote X9 软件排除重复研究。使用 Stata 15.1 软件对纳入的风险因素进行荟萃分析。使用随机或固定效应模型合并分析纳入风险因素的比值比（OR）和 95%置信区间（CI）。采用 Q 和 I2 检验分析异质性。采用 Egger 线性回归法评价纳入文章的发表偏倚。采用敏感性分析分析异质性的来源。
本研究共纳入 13 篇文章。对 15 个危险因素进行了荟萃分析。其中，入院前住院记录（OR=5.18，95%CI：1.45-18.51，P=0.011）、入院前抗生素使用（OR=2.17，95%CI：1.24-3.79，P=0.006）、糖尿病类型（OR=2.44，95%CI：1.29-4.64，P=0.006）、溃疡类型（OR=2.17，95%CI：1.06-4.41，P=0.033）、溃疡大小（OR=2.56，95%CI：1.53-4.28，P<0.001）、骨髓炎（OR=3.50，95%CI：2.37-5.16，P<0.001）、血管疾病（OR=2.37，95%CI：1.41-3.99，P=0.001）、手术治疗（OR=4.80，95%CI：2.95-7.83，P<0.001），这些荟萃分析结果具有统计学差异，可视为 MDRO 感染的危险因素。
DFU 患者 MDRO 感染的危险因素包括入院前住院记录、入院前抗生素使用、糖尿病类型、溃疡类型、溃疡大小、骨髓炎、血管病变和手术治疗。本研究有助于提高 DFU 患者 MDRO 感染人群的早期识别和治疗能力，从而延缓疾病的发展。
