Distribution of pathogens in diabetic foot osteomyelitis and risk factors of osteomyelitis / 南方医科大学学报
Journal of Southern Medical University
; (12): 1782-1786, 2015.
Article
in Chinese
| WPRIM (Western Pacific)
| ID: wpr-232527
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To explore the distribution and antibiotic resistance of pathogens in lesions of diabetic foot osteomyelitis (DFO) and analyze the risk factors causing osteomyelitis.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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 cm(2) were the risk factors for osteomyelitis in patients with diabetic foot infections (P<0.05).</p><p><b>CONCLUSION</b>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 cm(2) are exposed to an increased risk of osteomyelitis.</p>
Full text:
Available
Health context:
Neglected Diseases
Health problem:
Zoonoses
Database:
WPRIM (Western Pacific)
Main subject:
Osteomyelitis
/
Wound Infection
/
Cephalosporins
/
Risk Factors
/
Classification
/
Diabetic Foot
/
Drug Resistance, Multiple, Bacterial
/
Gram-Negative Bacteria
/
Gram-Positive Bacteria
/
Microbiology
Type of study:
Etiology study
/
Risk factors
Limits:
Humans
Language:
Chinese
Journal:
Journal of Southern Medical University
Year:
2015
Document type:
Article