The Distribution Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot were Correlated with Different Wagner Grades

Feixue QIN; Juankun HE; Shi LIU; Bin WEN; Hong ZHU; Jing LI; Li GUI; Xiaoyan CAO

doi:10.12259/j.issn.2095-610X.S20250210

Volume 46 Issue 2

Feb. 2025

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Feixue QIN, Juankun HE, Shi LIU, Bin WEN, Hong ZHU, Jing LI, Li GUI, Xiaoyan CAO. The Distribution Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot were Correlated with Different Wagner Grades[J]. Journal of Kunming Medical University, 2025, 46(2): 67-73. doi: 10.12259/j.issn.2095-610X.S20250210

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Feixue QIN, Juankun HE, Shi LIU, Bin WEN, Hong ZHU, Jing LI, Li GUI, Xiaoyan CAO. The Distribution Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot were Correlated with Different Wagner Grades[J]. Journal of Kunming Medical University, 2025, 46(2): 67-73. doi: 10.12259/j.issn.2095-610X.S20250210

Citation:

Feixue QIN, Juankun HE, Shi LIU, Bin WEN, Hong ZHU, Jing LI, Li GUI, Xiaoyan CAO. The Distribution Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot were Correlated with Different Wagner Grades[J]. Journal of Kunming Medical University, 2025, 46(2): 67-73. doi: 10.12259/j.issn.2095-610X.S20250210

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The Distribution Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot were Correlated with Different Wagner Grades

doi: 10.12259/j.issn.2095-610X.S20250210

Feixue QIN¹,
Juankun HE¹,
Shi LIU¹,
Bin WEN¹,
Hong ZHU²,
Jing LI³,
Li GUI^{1, 2
,
,},
Xiaoyan CAO^{2
,
,}

1.
School of Clinical Medicine，Dali University，Dali Yunnan 671003
2.
Department of Endocrinology，The Third People's Hospital of Yunnan Province，Kunming Yunnan 650011
3.
Yunnan Provincial Key Laboratory of Public Health and Biosafety and College of Public Health，Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2024-10-08
Available Online: 2025-01-04
Publish Date: 2025-02-18

Abstract

Abstract

Objective To study the pathogenic bacteria infection in hospitalized diabetic foot patients in the Third People's Hospital of Yunnan Province and its correlation with different Wagner grades, to understand the the characteristics of pathogenic bacteria and related risk factors in hospitalized diabetic foot patients in the Third People's Hospital of Yunnan Province, and to further provide theoretical guidance for anti-infection treatment of these patients. Methods A retrospective analysis was conducted on the demographic data, severity of foot ulcers, and related laboratory test results of 536 patients with diabetic foot who were detected to have bacterial infection in the Third People's Hospital of Yunnan Province from January 2019 to January 2023. Results Among the 536 diabetic foot patients, pathogenic bacteria were cultured from 268 cases （50.0%） of Gram-positive bacterial infections, 214 cases（39.9%） of gram-negative bacterial infections, 2 cases（0.4%） of fungal infections, and 52 cases （9.7%） of mixed bacterial infections. The main pathogens among gram-positive bacteria were Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis. for Gram-negative bacteria, the main pathogens were Escherichia coli, Enterobacter cloacae and Klebsiella pneumoniae.There were 31 cases of multi-drug resistant bacteria, and the multi-drug resistance rate was （5.78%）. Among Gram-positive bacteria, all multidrug-resistant strains were Staphylococcus aureus, while among Gram-negative bacteria, the multi-drug resistant strains included Acinetobacter baumannii （1 case）, Klebsiella pneumoniae （2 cases）, Proteus common （2 cases）, Pseudomonas aeruginosa （5 cases）, Proteus mirabilis （1 case） and Enterobacter cloacae （1 case）. The 536 patients were divided into Wagner grade 1 and 2 groups （78 cases）, Wagner grade 3 group （274 cases）, and Wagner grade 4 and 5 groups （184 cases）. There were 73 cases of single bacterial infections and 5 cases of mixed bacterial infections in Wagner grade 1 and 2 group, including 51 cases （65.4%） of gram-positive bacteria, 21 cases （26.9%） of gram-negative bacteria and 1 case （1.3%） of fungi. There were 248 cases of single bacterial infections and 26 cases of mixed bacterial infections in Wagner3 group, with 144 cases （52.6%） of gram-positive bacteria, 103 cases （37.6%） of gram-negative bacteria, and 1 case （0.4%） with fungi. In the Wagner grade 4 and 5 groups, there were 163 cases of single bacterial infections and 21 cases of mixed bacterial infection, with 73 strains（ 39.7%） of gram-positive bacteria, 90 strains （48.9%） of gram-negative bacteria and 0 strain （0%） of fungi.The predominant infectious pathogens in Wagner grades 1, 2 and 3 were gram-positive bacteria, while those in Wagner grades 4 and 5 patients were mainly gram-negative bacteria. There were statistically significant differences in white blood cell counts, neutrophil percentage, bacterial classification, length of hospital stay, erythrocyte sedimentation rate and albumin levels among diabetic foot patients with different Wagner grades （P < 0.01）. With the increase of Wagner grade, patients had higher white blood cell counts and hypersensitive C-reactive protein levels, longer hospital stays, and lower albumin levels; however, there were no statistically significant differences in age, sex, duration of diabetes, smoking history, alcohol consumption history and history of hypertension （P > 0.05）. Conclusion The bacterial infection situation in patients with diabetic foot ulcers is related to different Wagner grades. The higher the Wagner grades, the greater the likelihood of infection with gram-negative bacteria. Antibiotics can be reasonably selected according to the Wagner grades of patients upon admission, actively controlling infection, while also enhancing, shortening hospital stays, and reducing amputation rates, thereby improving the prognosis of diabetic foot patients.
- Diabetes mellitus,
- Diabetic foot,
- Pathogenic bacteria,
- Wagner classification

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References(26)

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