Distribution of pathogens in diabetic foot osteomyelitis and risk factors of osteomyelitis
10.3969/j.issn.1673-4254.2015.12.23
- VernacularTitle:糖尿病足合并骨髓炎创面病原菌分布及危险因素分析
- Author:
Ying HUANG
1
;
Ying CAO
;
Mengchen ZOU
;
Wenxia LI
;
Xiangrong LUO
;
Ya JIANG
;
Yaoming XUE
;
Fang GAO
Author Information
1. 南方医科大学南方医院内分泌代谢科
- Keywords:
diabetic foot;
osteomyelitis;
pathogenic bacteria;
risk factors
- From:
Journal of Southern Medical University
2015;(12):1782-1786
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the distribution and antibiotic resistance of pathogens in lesions of diabetic foot osteomyelitis (DFO) and analyze the risk factors causing osteomyelitis. Methods A total of 372 patients with diabetic foot infections hospitalized between January 2011 and December 2014, including 203 with osteomyelitis (OM group) and 169 without osteomyelitis (non-OM group), were examined for the distribution and antibiotic resistance profile of the pathogens in the wounds. Logistic regression analysis was used to analyze the risk factors causing osteomyelitis. Results Gram-negative bacteria were the predominant pathogens (53.7%) in the infected wounds in OM group, whereas Gram-positive bacteria were the most frequently found (56.7%) in non-OM group (P=0.001). Among the Gram-positive bacteria, Staphylococcus was the dominating flora (35.1%). The resistance rate to oxacillin and cefoxitin of the isolated bacteria in OM group (64.9%and 68.5%, respectively) was significantly higher than that in non-OM group (29.2%and 32.6%, respectively;P<0.05). Among the gram-negative bacteria, Enterobacteriaceae was the dominating flora (62.4%), with a higher resistance rate to Cefepime and Aztreonam in OM group (30.1% and 38.6%, respectively) than in non-OM group (15.1% and 22.2%, respectively; P<0.05). Logistic regression analysis indicated that the infection by multi-drug resistant bacteria and an wounds area >4 cm2 were the risk factors for osteomyelitis in patients with diabetic foot infections (P<0.05). Conclusions In addition to an empirical anti-infection therapy, clinicians should choose specific antibiotics against Gram-negative bacteria according to the microbial spectrum and antibiotic resistance of pathogens in patients with DFO; patients with diabetic foot infections by multi-drug resistant bacteria and those with a wound area exceeding 4 cm2 are exposed to an increased risk of osteomyelitis.
