Correlation Analysis of Drug Resistance Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot Infection

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

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Juankun HE, Feixue QIN, Bin WEN, Shi LIU, Jing LI, Li GUI, Hong ZHU. Correlation Analysis of Drug Resistance Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot Infection[J]. Journal of Kunming Medical University.

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Correlation Analysis of Drug Resistance Characteristics of Pathogenic Bacteria in Inpatients with Diabetic Foot Infection

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

1.
School of Clinical Medicine，Dali University，Dali Yunnan 671003
2.
Dept. of Endocrinology，The Third People’s Hospital of Yunnan Province，Kunming Yunnan 650011
3.
Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2024-09-30

Abstract

Abstract

Objective To analyze the bacterial distribution characteristics, drug resistance characteristics and related risk factors of multidrug-resistant organisms （MDRO） in patients with diabetic foot infection （DFI） in some areas of Yunnan Province to provide empirical reference for clinical treatment. Methods Clinical data of 300 DFI patients admitted to the Department of Endocrinology of the Third People's Hospital of Yunnan Province from January 2019 to December 2023 were collected. Based on the results of drug sensitivity tests and matching of basic data, patients were divided into the MDRO group （n = 60） and the non-MDRO group （n = 240）. A retrospective analysis was conducted on the distribution of pathogenic bacteria, drug resistance characteristics of MDRO and risk factors for MDRO infection in DFI patients. Results In 60 patients with MDRO infections, 62 strains of MDRO were cultured, with 58 strains from single MDRO infections and 4 strains from mixed MDRO infections. Of the 60 patients, 2 were cultured for 2 types of MDRO. Among the strains, there were 45 gram-positive bacteria （72.58%） which were all Staphylococcus aureus, there were 17 strains of gram-negative bacteria （27.42%） mainly including Pseudomonas aeruginosa, Enterobacter cloacae and Klebsiella pneumoniae. Among common MDRO, Staphylococcus aureus showed complete resistance to penicillin G and oxacillin（100%）, with high resistance to erythromycin and clindamycin （ > 80%）, but no resistance to tigacycline vancomycin was observed;The resistance of Klebsiella pneumoniae and Enterobacter cloacae to cephalosporin antibiotics was obvious, and the resistance rate to imipenem and amikacin was low; Pseudomonas aeruginosa was 100% resistant to ticacillin/clavulanate potassium, imipenem, tigacycline and cotrimoxazole, but showed no resistance to cefepime, ciprofloxacin, gentamicin and amikacin. There were statistically significant differences between the two groups in regional distribution, duration of diabetic foot, lower extremity arterial disease, venous plasma glucose levels and glycosylated hemoglobin （P < 0.05）. Binary Logistic regression analysis showed that region and duration of diabetic foot disease were independent risk factors for MDRO infection in DFI patients （P < 0.05）. Conclusion In some areas of Yunnan Province, the distribution of MDRO in DFI patients is mainly gram-positive bacteria, with varying antibiotic sensitivities among different pathogens. Multiple factors lead to MDRO infections in DFI patients, which assists clinical practitioners in early identification of high-risk DFI patients with MDRO infections and provide empirical reference for clinical treatment.
- Diabetic foot infection,
- Pathogen resistance,
- Risk factor,
- Management measures

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References(26)

References

[1]	Wang A,Lv G,Cheng X,et al. Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)[J]. Burns Trauma,2020,8:tkaa017. doi: 10.1093/burnst/tkaa017
[2]	谷涌泉,冉兴无,郭连瑞,等. 中国糖尿病足诊治指南[J]. 中国临床医生杂志,2024,52(11):1287-1296. doi: 10.3969/j.issn.2095-8552.2024.11.007
[3]	Zhang P,Lu J,Jing Y,et al. Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis †[J]. Annals of Medicine,2017,49(2):106-116. doi: 10.1080/07853890.2016.1231932
[4]	中华医学会糖尿病学分会,中华医学会感染病学分会,中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)(Ⅰ)[J]. 中华糖尿病杂志,2019,11(2):92-108. doi: 10.3760/cma.j.issn.1674-5809.2019.02.004
[5]	赵晨旭,周慧敏. 《中国糖尿病足诊治指南》解读[J]. 中国临床医生杂志,2021,49(12):1405-1408. doi: 10.3969/j.issn.2095-8552.2021.12.007
[6]	徐斌,李阳阳. 糖尿病足多重耐药菌感染的分布及耐药性的危险因素分析[J]. 实用医院临床杂志,2021,18(4):188-192. doi: 10.3969/j.issn.1672-6170.2021.04.054
[7]	American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2019[J]. Diabetes Care,2019,42(Suppl 1):S13-S28.
[8]	Lipsky B A,Senneville É,Abbas Z G,et al. Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)[J]. Diabetes/Metabolism Research and Reviews,2020,36(Suppl 1):e3280.
[9]	Clinical and Laboratory Standards Institute. M100S. Performance standards for antimicrobial susceptibility testing: twenty-sixth edition[S]. Wayne,PA: CLSI,2016.
[10]	黄勋,邓子德,倪语星,等. 多重耐药菌医院感染预防与控制中国专家共识[J]. 中国感染控制杂志,2015,14(1):1-9. doi: 10.3969/j.issn.1671-9638.2015.01.001
[11]	Saeedi P,Petersohn I,Salpea P,et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas,9th edition[J]. Diabetes Research and Clinical Practice,2019,157:107843. doi: 10.1016/j.diabres.2019.107843
[12]	Zubair M,Ahmad J. Potential risk factors and outcomes of infection with multidrug resistance among diabetic patients having ulcers: 7 years study[J]. Diabetes & Metabolic Syndrome,2019,13(1):414-418.
[13]	Xia W,He W,Luo T,et al. Risk factors for multidrug-resistant bacterial infections in patients with diabetic foot ulcers: A systematic review and meta-analysis.[J]. Annals of palliative medicine,2021,10(12):12618-12630. doi: 10.21037/apm-21-3406
[14]	Matheson E M,Bragg S W,Blackwelder R S. Diabetes-Related foot infections: diagnosis and treatment[J]. American Family Physician,2021,104(4):386-394.
[15]	Adeyemo A T,Kolawole B,Rotimi V O,et al. Multicentre study of the burden of multidrug-resistant bacteria in the aetiology of infected diabetic foot ulcers[J]. African Journal of Laboratory Medicine,2021,10(1):1261.
[16]	Guo H,Song Q,Mei S,et al. Distribution of multidrug-resistant bacterial infections in diabetic foot ulcers and risk factors for drug resistance: A retrospective analysis[J]. PeerJ,2023,11:e16162. doi: 10.7717/peerj.16162
[17]	Li T,Li Z,Huang L,et al. Cigarette smoking and peripheral vascular disease are associated with increasing risk of ESKAPE pathogen infection in diabetic foot ulcers[J]. Diabetes,Metabolic Syndrome and Obesity: Targets and Therapy,2022,15:3271-3283.
[18]	Atlaw A,Kebede H B,Abdela A A,et al. Bacterial isolates from diabetic foot ulcers and their antimicrobial resistance profile from selected hospitals in Addis Ababa,Ethiopia[J]. Frontiers in Endocrinology,2022,13:987487. doi: 10.3389/fendo.2022.987487
[19]	邓飞,沈亚非,常红娟. 糖尿病足患者多药耐药菌感染病原学及其影响因素[J]. 中华医院感染学杂志,2023,33(15):2300-2304.
[20]	Yaghoubi S,Zekiy A O,Krutova M,et al. Tigecycline antibacterial activity,clinical effectiveness,and mechanisms and epidemiology of resistance: narrative review[J]. Eur J Clin Microbiol Infect Dis,2022,41(7):1003-1022. doi: 10.1007/s10096-020-04121-1
[21]	王维霞,王明贵. 基于非劣效性临床试验获批准后替加环素相关的死亡增多[J]. 中国感染与化疗杂志,2012,12(06):476.
[22]	Uçkay I,Berli M,Sendi P,et al. Principles and practice of antibiotic stewardship in the management of diabetic foot infections[J]. Curr Opin Infect Dis,2019,32(2):95-101. doi: 10.1097/QCO.0000000000000530
[23]	谷宏伟,李希娜,魏华,等. 糖尿病足溃疡患者细菌感染特点及耐药影响因素分析[J]. 临床药物治疗杂志,2022,20(11):76-79. doi: 10.3969/j.issn.1672-3384.2022.11.016
[24]	Yan X,Song J fang,Zhang L,et al. Analysis of risk factors for multidrug-resistant organisms in diabetic foot infection[J]. BMC Endocrine Disorders,2022,22(1):46. doi: 10.1186/s12902-022-00957-0
[25]	陈丽华,杨婧,伍勇. 糖尿病足患者足分泌物分离菌分布及多重耐药影响因素分析[J]. 中国抗生素杂志,2018,43(10):1286-1290. doi: 10.3969/j.issn.1001-8689.2018.10.021
[26]	Liu X,Ren Q,Zhai Y,et al. Risk factors for multidrug-resistant organisms infection in diabetic foot ulcer[J]. Infection and Drug Resistance,2022,15:1627-1635. doi: 10.2147/IDR.S359157

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