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 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.
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, HbA 1C, 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.