Distribution characteristics of pathogen and antibiotic susceptibility in diabetic foot osteomyelitis
10.3760/cma.j.issn.1000-6699.2020.02.006
- VernacularTitle: 糖尿病足患者骨髓炎病原菌分布特点及药敏分析
- Author:
Meng LI
1
;
Huifeng ZHANG
1
;
Erhui XIAO
2
;
Shanmei WANG
3
;
Yanan QI
4
;
Jing LUO
4
Author Information
1. Department of Endocrinology, Henan University People′s Hospital, Zhengzhou 450003, China
2. Department of Infections, Henan Provincial People′s Hospital, Zhengzhou 450003, China
3. Department of Inspection, Henan Provincial People′s Hospital, Zhengzhou 450003, China
4. Department of Endocrinology, Henan Provincial People′s Hospital, Zhengzhou 450003, China
- Publication Type:Clinical Trail
- Keywords:
Diabetic foot osteomyelitis;
Bone biopsy;
Bone culture;
Basal tissue culture;
Pathogen;
Antibiotics
- From:
Chinese Journal of Endocrinology and Metabolism
2020;36(2):120-126
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze distribution characteristics of pathogenic bacteria and their antimicrobial susceptibility in patients with diabetic foot osteomyelitis(DFO).
Methods:Sixty cases of suspected DFO were collected from the Endocrinology Department of Henan Provincial People′s Hospital. After admission, bone biopsy was carried out to confirm the pathological diagnosis, and the pathogenic bacteria and drug sensitivity were determined by bone culture. In addition, bacterial culture was carried out in the basal tissue of the wound, and the results of bacterial culture were compared with those of bone culture.
Results:Sixty patients were diagnosed as DFO after bone biopsy. Among the 60 patients, 45 patients underwent bone culture and basal tissue culture. There are 24 patients of whom the results were consistent, accounting for 53.3%. The positive rate of bone culture was 55.0%, there were 16 strains of gram-positive bacteria and 22 strains of gram-negative bacteria. Staphylococcus aureus(9 strains) occurrence was the most, common finding, followed by Escherichia coli(6 strains). The course of diabetic foot, albumin(ALB), and antibiotic usage rate before admission were lower in bone culture positive group than those in bone culture negative group, while white blood cell(WBC) and C-reactive protein(CRP) were higher in bone culture negative group(P<0.05). There was no significant difference in gender, age, course of diabetes, HbA1C, and creatinine(CREA) levels between the two groups(P>0.05). The results of bone culture showed that Staphylococcus aureus was the main Gram-positive bacteria, which was more sensitive to vancomycin, tigecyclin, linezolid, etc. Escherichia coli was the main Gram-negative bacteria, which was more sensitive to tigecyclin, carbapenems, amikacin, etc.
Conclusion:Bone biopsy and bone culture should be carried out in cases for suspected DFO patients to identify the pathogenic bacteria, and the bone tissue should be preserved and obtained according to the operation specification before the application of antibiotics, and the appropriate antibiotics should be selected according to the drug sensitivity results.
