ABSTRACT
Objective:To retrospectively analyze clinical characteristics, flora distribution characteristics, and antimicrobial sensitivity of type 2 diabetic patients with back abscess.Methods:The clinical data of patients with type 2 diabetes mellitus and back abscess were collected from Endocrinology Department of Henan Provincial People′s Hospital from October 2017 to April 2020. The results of bacterial culture and drug sensitivity test were analyzed, antibiotics were given to treat infection, incision and debridement of abscess were performed according to the situation of abscess, drainage of abscess cavity or continuous negative pressure suction was given when necessary, and the clinical outcome was recorded.Results:A total of 12 type 2 diabetic patients with back abscess were included. The average size of their abscess was(150.3±101.2)cm 2, with over 100 cm 2 in 8 cases(66.7%). Among the 12 patients, 11 patients underwent bacterial culture and drug sensitivity analysis. The positive rate of culture was 100%, and all of them were Staphylococcus aureus, with 10 cases of methicillin-susceptible Staphylococcus aureus(MSSA)and 1 case of methicillin-resistant Staphylococcus aureus(MRSA). MSSA strains were 100% sensitive to oxacillin, vancomycin, linezolid, levofloxacin, moxifloxacin, tetracycline, tegecycline, rifampicin, amoxicillin/clavulanic acid, amikacin, and teicoplanin. Both MSSA and MRSA strains were sensitive to vancomycin, linezolid, rifampin, amikacin, and teicoplanin. The wound of all patients was healed, with 100% cure rate and(35.8±34.0)days of average healing time. Conclusion:The back abscess in type 2 diabetic patients is characteristic of rapid progress, huge abscess, and difficult to treat, which should be treated early, incised and debrided timely. Staphylococcus aureus is its single pathogen and it is helpful to select the antibiotics empirically.
ABSTRACT
Objective To investigate the early diagnostic value of cornel confocal microscopy for the screening of small neuropathy in elderly patients with type 2 diabetic mellitus.Methods In the prospective study,96 elderly patients with diabetes as study group and 46 patients with non-diabetes as the control group were continuously collected from our hospital endocrinology and ophthalmology out patients during May 2014 to February 2016.The 96 cases of type 2 diabetes were subdivided into 47 patients with diabetic peripheral neuropathy (DPN)and 47 patients with nowdiabetic peripheral neuropathy(non DPN).Results The diabetes course was shorter in non-DPN group than in DPN group(P=0.000).The levels of glycosylated hemoglobin and urine albumin were lower in the nonDPN than in the DPN(P =0.072,0.007,respectively).The corneal nerve fiber density was lower in the DPN group than in NDPN group (P =0.000).Corneal nerve fiber density was higher in control group than in DPN and NDPN group.The differences in number of corneal nerve fibers showed no statistical significance between DPN and NDPN group (x2 =2.391,P =0.314).But the number of corneal nerve fibers was significant less in DPN and NDPN group than in control group(x2 =16.014,P =0.000).The negative correlation was found between the course of disease and corneal fibrous density by using single factor linear regression analysis.The number of corneal nerve fibers was lower in smoking group than in non-smoking group(P=0.003).The multiple linear regression analysis showed that duration of diabetes was a risk factor for diabetic neuropathy.Conclusions In some elderly diabetic patients with non-neuropathy,corneal nerve fiber density and number have been significantly decreased before nerve conductive velocity is reduced.Therefore,corneal confocal microscopy can be used to detect and diagnose small diabetic neuropathy in elderly patients with diabetes mellitus.