Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, US.
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, US.
J Wound Care. 2023 Jul 1;32(Sup7):S19-S25. doi: 10.12968/jowc.2023.32.Sup7.S19.
Group B (GBS) is a common pathogen in diabetic foot ulcers (DFUs), where it has been found to result in higher rates of soft tissue infection and amputation despite appropriate treatment. In this study, we aim to investigate clinical characteristics and prognosis of GBS DFU infections, especially those with tenosynovial involvement. We hypothesise that GBS-infected DFUs with tenosynovial involvement leads to an increased number of recurrent infections and unexpected returns to the operating room.
Data were retrospectively collected from GBS-infected DFU patients surgically treated by an orthopaedic foot and ankle surgeon over a four-year period. Demographics, comorbidities, initial laboratory values and culture results from infected bone samples were recorded. Clinical outcome was assessed by recurrent infection and unplanned reoperation(s) within 3 months following the initial surgery.
In total, 72 patients were treated for GBS-infected DFUs. Intra-operative culture of infected bone identified GBS in 16 patients (22.2%). Significantly more black patients (p=0.017) were afflicted by GBS DFUs. Patients with GBS DFUs had higher initial haemoglobin A1C levels (p=0.019), and those with tenosynovial involvement were likely to require reoperation (p=0.036) and had a greater total number of surgeries (p=0.015) than those without.
GBS-infected DFUs are more common in black patients and those with elevated haemoglobin A1Cs. GBS infections with tenosynovial involvement are particularly destructive and require aggressive treatment by surgeons.
B 群链球菌（GBS）是糖尿病足溃疡（DFU）的常见病原体，尽管进行了适当的治疗，但它仍会导致更高的软组织感染和截肢率。在这项研究中，我们旨在研究 GBS 所致 DFU 感染的临床特征和预后，特别是伴有腱鞘炎的感染。我们假设，伴有腱鞘炎的 GBS 感染性 DFU 会导致更多的复发性感染和意想不到的重返手术室。
对一名骨科足踝外科医生在四年期间手术治疗的 GBS 感染性 DFU 患者进行回顾性数据收集。记录了患者的人口统计学资料、合并症、初始实验室值和感染骨样本的培养结果。通过初始手术后 3 个月内的复发性感染和意外再次手术评估临床结局。
共治疗 72 例 GBS 感染性 DFU 患者。感染骨的术中培养发现 16 例（22.2%）存在 GBS。受 GBS 感染性 DFU 影响的黑人患者明显更多（p=0.017）。GBS 感染性 DFU 患者的初始血红蛋白 A1C 水平更高（p=0.019），伴有腱鞘炎的患者更有可能需要再次手术（p=0.036），并且总手术次数更多（p=0.015）。
GBS 感染性 DFU 在黑人患者和血红蛋白 A1C 升高的患者中更为常见。伴有腱鞘炎的 GBS 感染特别具有破坏性，需要外科医生进行积极治疗。
