Effects of common bacterial infections in patients with diabetic foot ulcer on long-term outcome—3 years follow-up
10.3760/cma.j.issn.1000-6699.2019.08.006
- VernacularTitle:常见不同细菌感染对糖尿病足溃疡患者预后影响的三年随访分析
- Author:
Shanshan ZHANG
1
;
Shumin WANG
;
Yang HE
;
Lei XU
;
Hongjie QIAN
;
Xueming GU
;
Zhengyi TANG
Author Information
1. 胜利油田中心医院内分泌科
- Keywords:
Diabetic foot ulcer;
Bacterial infection;
Wound healing;
Cardiac and cerebrovascular events;
Death
- From:
Chinese Journal of Endocrinology and Metabolism
2019;35(8):678-684
- CountryChina
- Language:Chinese
-
Abstract:
Objective Most common infected bacteria were found to analyze their effects on clinical characteristics and 3-year outcome of patients with diabetic foot ulcer ( DFU ) . Methods Materials of cases with positive bacterial culture were selected from DFU patients. 203 cases were infected with the most common 6 strains of mono-bacteria, and 62 cases were infected with multi-bacteria. Data were grouped according to the most common 6 infected bacteria. The outcomes of healing, recurrence, amputation, cardiac events, cerebrovascular events and death were calculated of 3 years after hospitalization. Clinical characteristics of mono-and multi-infected groups and these 6 mono-bacterial infection groups, and risk factors to outcome were analyzed. Results No significant difference was found in baseline clinical characteristics, cardiac and cerebrovascular events, and death during follow-up between mono-and multi-infected groups. The most common 6 infected bacteria were staphylococcus aureus, pseudomonas aeruginosa, proteus, enterococcus faecalis, escherichia coli and klebsiella pneumoniae. Among these groups, there were no significant differences of baseline clinical characteristics and recurrence, cardiac and cerebrovascular events, and death except for the foot ulcer and foot ulcer related prognosis. In staphylococcus aureus infected group, severe lower extremity arterial disease (8.5％), Wagner grade 3-5 (48.9％), moderate and severe infection rate (34.0％) were significantly lower than other groups, and the healing rate ( 93. 6％) was higher than other groups ( all P<0.05). Severe lower extremity arterial disease, cardiac function grading over 3(NYHA), eGFR<60 ml·min-1· (1.73 m2)-1, duration of DFU over 30 days were the main risk factors for ulcers′healing. Wagner grade over 3 was main risk factor for minor amputation. Severe lower extremity arterial disease, Hb<90g/L were the main risk factors for major amputation. Cardiac function grading over 3 ( NYHA ) was main risk factor for cardiac events, and also for death. ALB<30 g/L was main risk factor for death (all P<0.05). Conclusion DFU patients infected with different strains of bacteria were significantly different in foot ulcer and healing rate, while not in cardiac and cerebrovascular events and death.
