Kulasegaran Nandini, Vangaveti Venkat, Norton Robert, Malabu Usman
University of Queensland, Brisbane, Queensland, Australia.
College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
Foot Ankle Orthop. 2024 Sep 30;9(3):24730114241281503. doi: 10.1177/24730114241281503. eCollection 2024 Jul.
Diabetic foot osteomyelitis (DFO) commonly occurs secondary to ulcerations of the skin. Empirical antibiotic agents are a key element of treatment and their use is dependent on local knowledge of the microbial spectrum of diabetic foot infections. This study aimed to retrospectively analyze the local microbiological profile, including bacterial culture/sensitivity results of DFO, and compare findings with literature. This study also aimed to review the concordance of microbiology results with national guidelines for the future treatment of DFO.
A retrospective review of clinical records was performed on patients who presented to the high-risk foot clinic, Townsville University Hospital, between 2018 and 2022. All patients older than 18 years and diagnosed with DFO were included. Our exclusion criteria included all other foot presentations, including trauma, vasculitis, and neoplasms.
On the basis of the inclusion and exclusion criteria, 124 patients with DFO were selected. Most patients in the cohort were males (70.2%), non-Indigenous (68.5%), aged 50-69 years (55.6%), and with elevated HbA levels (>8.6). Chronic kidney disease (39.5%) and ischemic heart disease (41.9%) were common comorbidities. Of the pertinent microbial results, (~76%) was the most commonly isolated Gram-positive organism. Gram-positive bacteria were significantly increased in the elderly population with DFO ( < .05). All methicillin-resistant isolates were vancomycin- and cotrimoxazole-sensitive. was the predominant Gram-negative organism isolated (39.3%). exhibited low sensitivity to ciprofloxacin.
This study has enhanced our understanding of the various microbial species underlying DFO at our center and may be generalizable.
Level IV, retrospective case series.
糖尿病足骨髓炎（DFO）通常继发于皮肤溃疡。经验性抗生素是治疗的关键要素，其使用取决于对糖尿病足感染微生物谱的当地了解。本研究旨在回顾性分析DFO的局部微生物学特征，包括细菌培养/药敏结果，并将结果与文献进行比较。本研究还旨在审查微生物学结果与未来DFO治疗国家指南的一致性。
对2018年至2022年期间在汤斯维尔大学医院高危足病诊所就诊的患者进行临床记录回顾性分析。纳入所有年龄大于18岁且诊断为DFO的患者。我们的排除标准包括所有其他足部疾病，如创伤、血管炎和肿瘤。
根据纳入和排除标准，选择了124例DFO患者。队列中的大多数患者为男性（70.2%）、非原住民（68.5%）、年龄在50 - 69岁之间（55.6%），且糖化血红蛋白水平升高（>8.6）。慢性肾病（39.5%）和缺血性心脏病（41.9%）是常见的合并症。在相关微生物结果中，（~76%）是最常分离出的革兰氏阳性菌。患有DFO的老年人群中革兰氏阳性菌显著增加（<.05）。所有耐甲氧西林分离株对万古霉素和复方新诺明敏感。是分离出的主要革兰氏阴性菌（39.3%）。对环丙沙星敏感性较低。
本研究增进了我们对本中心DFO潜在各种微生物种类的理解，且可能具有普遍性。
IV级，回顾性病例系列。
