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糖尿病足溃疡患者中多重耐药菌感染的分布及耐药危险因素分析:一项回顾性研究

Distribution of multidrug-resistant bacterial infections in diabetic foot ulcers and risk factors for drug resistance: a retrospective analysis.

机构信息

Department of Orthopaedic Surgery, Fuyang People's Hospital, Fuyang, China.

出版信息

PeerJ. 2023 Oct 9;11:e16162. doi: 10.7717/peerj.16162. eCollection 2023.

Abstract

OBJECTIVE

To investigate the distribution, drug resistance and risk factors of multi-drug resistant bacterias (MDROs) in patients with Type 2 diabetic foot ulcers (DFU).

METHOD

The clinical data, foot secretions, pathogenic microorganisms and drug sensitivity tests of 147 patients with type 2 diabetes admitted to our department from January 2018 to December 2021 were analyzed. Patients were divided into two groups according to whether they had been infected with MDROs or not. Seventy-one cases were infected with MDROs as the case group, and the remaining 76 cases were the control group. Chi-square test and t-test were used to analyze the results of MDROs infection and DFU, and logistic multivariate regression was used to evaluate the risk factors of MDROs infection.

RESULTS

A total of 71 strains were isolated from the MDROs-positive group, with the top three being Staphylococcus aureus (46.48%), (22.53%), and Pseudomonas aeruginosa (18.31%), respectively. Logistic multifactorial regression analysis showed that history of previous antimicrobial exposure, neuroischemic wound, Wagner grade 3-5, and combined osteomyelitis were associated with Type 2 diabetic foot infection MDROs ( < 0.05).

CONCLUSION

Previous history of antimicrobial exposure, neuroischemic wounds, Wagner grade 3-5, and combined osteomyelitis are independent risk factors for MDROs, which can identify the risk factors for MDROs at an early stage and help to identify people at high risk of MDROs infection and take relevant comprehensive treatment in time to slow down the development of the disease.

摘要

目的

探讨 2 型糖尿病足溃疡(DFU)患者中多重耐药菌(MDROs)的分布、耐药性及危险因素。

方法

回顾性分析 2018 年 1 月至 2021 年 12 月本科收治的 147 例 2 型糖尿病患者的临床资料、足部分泌物、病原菌及药敏试验。根据患者是否感染 MDROs 将其分为两组,71 例感染 MDROs 作为病例组,其余 76 例为对照组。采用卡方检验和 t 检验分析 MDROs 感染与 DFU 的结果,采用 logistic 多因素回归分析评估 MDROs 感染的危险因素。

结果

MDROs 阳性组共分离出 71 株病原菌,其中排名前三位的分别是金黄色葡萄球菌(46.48%)、大肠埃希菌(22.53%)和铜绿假单胞菌(18.31%)。logistic 多因素回归分析显示,既往抗菌药物暴露史、神经缺血性创面、Wagner 分级 3-5 级和合并骨髓炎与 2 型糖尿病足感染 MDROs 相关(<0.05)。

结论

既往抗菌药物暴露史、神经缺血性创面、Wagner 分级 3-5 级和合并骨髓炎是 MDROs 的独立危险因素,可以早期识别 MDROs 的危险因素,有助于识别 MDROs 感染的高危人群,并及时采取相关综合治疗,减缓疾病的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56ac/10569182/039fb91e935c/peerj-11-16162-g001.jpg

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