Alkhatieb Maram T, Alkhatieb Mahmood T, Abideen Raseel K, Alkhalifah Hussain A, Alnahdi Haifa M, Edrees Khalid M
Division of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Ministry of Health, Joint Program of Preventive Medicine Post Graduate Studies, Jeddah, Saudi Arabia.
J Family Med Prim Care. 2024 Jul;13(7):2724-2729. doi: 10.4103/jfmpc.jfmpc_12_24. Epub 2024 Jun 28.
Foot infections, a frequent complication of diabetes mellitus, are associated with heavy resource utilization, including antibiotic therapy and surgeries. However, the most common type of isolated pathogen in diabetic foot infections remains unknown. We aimed to identify the most common types of isolated pathogens in diabetic foot infections.
This retrospective cohort study was conducted in a specialized medical center in Jeddah, Saudi Arabia. A total of 96 patients diagnosed with diabetes and presented with a foot ulcer showing clinical signs of infection were included.
The mean age was 63.03 ± 10.88 years, and 67.7% were males. The mean duration of diabetes diagnosis was 21.86 ± 9.66 years, and the majority had foot ulcers for over six weeks. Bacteria were present in 65 patients (67.7%), Gram-negative organisms were observed in 37 patients (38.5%), and Gram-positive organisms were present in 28 patients (29.2%). In the 65 patients with bacterial culture, was the most common isolated organism and was observed in 18 patients (27.7%), followed by in 11 (16.9%) and in 10 (15.4%). Binary regression analyses found that Gram-negative organisms were significantly more multidrug-resistant than Gram-positive organisms ( = 0.012, OR = 7.172, 95% CI = 1.542-33.352). Patient outcomes included healed ulcers ( = 10, 10.4%), minor amputation ( = 16, 16.7%), major amputation ( = 1, 1%), and debridement ( = 48, 50%).
Gram-negative organisms were predominant in patients with diabetes and foot ulcers having clinical signs of infection. Treatment with an individualized antibiotic regimen is vital in ensuring optimal outcomes and preventing major amputations.
足部感染是糖尿病常见的并发症,与大量资源利用相关,包括抗生素治疗和手术。然而,糖尿病足感染中最常见的分离病原体类型仍不清楚。我们旨在确定糖尿病足感染中最常见的分离病原体类型。
这项回顾性队列研究在沙特阿拉伯吉达的一家专业医疗中心进行。共纳入96例诊断为糖尿病并出现足部溃疡且有感染临床体征的患者。
平均年龄为63.03±10.88岁,男性占67.7%。糖尿病诊断的平均时长为21.86±9.66年,大多数患者足部溃疡超过六周。65例患者(67.7%)存在细菌,37例患者(38.5%)观察到革兰氏阴性菌,28例患者(29.2%)存在革兰氏阳性菌。在65例进行细菌培养的患者中, 是最常见的分离菌,18例患者(27.7%)观察到该菌,其次是 有11例(16.9%), 有10例(15.4%)。二元回归分析发现,革兰氏阴性菌的多重耐药性显著高于革兰氏阳性菌( = 0.012,比值比 = 7.172,95%置信区间 = 1.542 - 33.352)。患者结局包括溃疡愈合( = 10,10.4%)、小截肢( = 16,16.7%)、大截肢( = 1,1%)和清创术( = 48,50%)。
在有感染临床体征的糖尿病和足部溃疡患者中,革兰氏阴性菌占主导。采用个体化抗生素方案治疗对于确保最佳结局和预防大截肢至关重要。