Yan Shufang, Zhu Xuemeng, Yu Tong, Li Dandan, Li Su, Xue Lei
Department of Endocrinology, Henan University Huaihe Hospital, Kaifeng, 475500, Henan, China.
Department of Pathology, Henan University Huaihe Hospital, Kaifeng, Henan, China.
Sci Rep. 2025 Jul 2;15(1):23553. doi: 10.1038/s41598-025-07092-5.
This study aimed to investigate the distribution of pathogenic microorganisms in diabetic foot infections (DFIs) and develop a nomogram to predict DFIs. It included 136 diabetic foot (DF) patients hospitalized at Henan University Huaihe Hospital from November 2020 to November 2024, with 86 (63.23%) having confirmed infections. Infections were predominantly caused by Gram-positive cocci (54.65%) and Gram-negative bacilli (43.02%). The nomogram incorporated age, C-reactive protein (CRP), Wagner grade, lower extremity arterial disease (LEAD), and peripheral neuropathy (PN). The predictive model exhibited robust discriminatory capacity, achieving an area under the curve (AUC) of 0.803 (95% confidence interval (CI) 0.735-0.878) with internal cross-validation stability (AUC = 0.804). Goodness-of-fit was confirmed by the Hosmer-Lemeshow test (χ = 5.014, p = 0.756), with excellent net benefit shown by decision curve analysis. Our findings indicate a high infection rate in DF patients, mainly caused by Gram-positive cocci. The nomogram incorporating age, CRP, Wagner grade, LEAD, and PN parameters enables rapid DFIs screening, facilitating timely antibiotic initiation through early infection detection to enhance clinical management.
本研究旨在调查糖尿病足感染（DFIs）中致病微生物的分布情况，并开发一种列线图以预测DFIs。该研究纳入了2020年11月至2024年11月在河南大学淮河医院住院的136例糖尿病足（DF）患者，其中86例（63.23%）确诊感染。感染主要由革兰氏阳性球菌（54.65%）和革兰氏阴性杆菌（43.02%）引起。列线图纳入了年龄、C反应蛋白（CRP）、瓦格纳分级、下肢动脉疾病（LEAD）和周围神经病变（PN）。该预测模型具有强大的区分能力，内部交叉验证稳定性下曲线下面积（AUC）为0.803（95%置信区间（CI）0.735 - 0.878）（AUC = 0.804）。Hosmer-Lemeshow检验证实了拟合优度（χ = 5.014，p = 0.756），决策曲线分析显示净效益良好。我们的研究结果表明DF患者感染率高，主要由革兰氏阳性球菌引起。纳入年龄、CRP、瓦格纳分级、LEAD和PN参数的列线图能够快速筛查DFIs，通过早期感染检测促进及时使用抗生素，以加强临床管理。
