Patel Simran, Jooste Emeline, Glynos Charalambia, Mbajiorgu Onyiyechukwu, Sipahlanga Anelisa, Ngubane Wandile, Maharaj Gopala, Moeng Maeyane Stephens, Luvhengo Thifhelimbilu Emmanuel
Unit of Undergraduate Medical Education, University of the Witwatersrand, Johannesburg 2017, South Africa.
Department of Surgery, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg 2193, South Africa.
Diagnostics (Basel). 2024 Dec 26;15(1):32. doi: 10.3390/diagnostics15010032.
: Diabetic foot sepsis (DFS) is the leading cause of lower extremity amputations and timely initiation of effective antimicrobial therapy is paramount during its management. This study investigated causative microorganisms and their antimicrobial susceptibility profile in patients with DFS. : A retrospective review was conducted on patients who were 18-years and older admitted with DFS. Data collected included demographic information, comorbidities, clinical findings, types of specimens collected and results of microscopy, culture, and sensitivity (MC&S), treatment, and outcomes. : One hundred and sixty-eight records were found, of which 64.3% were of male patients. The median (IQR) age of males was 58 years (IQR 54-65) compared to 61 years (IQR 54-67) for females. Results of MC&S were available in 63.1% of the records, and was cultured in 16%, in 10%, and in 8% of cases. Amoxicillin/Clavulanic acid was prescribed in 69% of the cases. Resistance to at least one antimicrobial was shown in 88% of and 80% of . : The commonly cultured organisms in patients with DFS were 16%, 10%, and . Amoxicillin/Clavulanic was prescribed empirically in 69% of the cases despite high rates of resistance, and in 37% treatment was not preceded by collection of specimens for MC&S. We therefore recommend collection of specimens for MC&S before initiation of antimicrobial therapy in all patients with DFS.
糖尿病足脓毒症(DFS)是下肢截肢的主要原因,在其治疗过程中及时启动有效的抗菌治疗至关重要。本研究调查了DFS患者的致病微生物及其抗菌药物敏感性谱。
对18岁及以上因DFS入院的患者进行了回顾性研究。收集的数据包括人口统计学信息、合并症、临床表现、采集的标本类型以及显微镜检查、培养和药敏试验(MC&S)结果、治疗情况和结局。
共找到168份记录,其中64.3%为男性患者记录。男性的年龄中位数(四分位间距)为58岁(四分位间距54 - 65岁),女性为61岁(四分位间距54 - 67岁)。63.1%的记录有MC&S结果,16%的病例培养出[具体微生物1],10%培养出[具体微生物2],8%培养出[具体微生物3]。69%的病例使用了阿莫西林/克拉维酸。[具体微生物1]中88%和[具体微生物2]中80%对至少一种抗菌药物耐药。
DFS患者中常见培养出的微生物为[具体微生物1](16%)、[具体微生物2](10%)和[具体微生物3]。尽管耐药率高,但69%的病例经验性使用了阿莫西林/克拉维酸,37%的病例在治疗前未采集标本进行MC&S。因此,我们建议所有DFS患者在开始抗菌治疗前采集标本进行MC&S。