Analysis Of Pathogenic Bacteria Distribution And Drug Resistance In Hospitalized Patients With Diabetic Foot Infection

Objective:The study was aim to explore the characteristics of pathogenic microorganisms,pathogenic bacteria distribution and drug resistance in patients with diabetic foot infection of different lesions in the region,to discuss the characteristics and influencing factors of mixed bacterial infection simultaneously.Methods:To conduct a comprehensive analysis of the clinical data of 498hospitalized DFI patients admitted and treated in the period of June 2017 to May2020.Clinical data was divided into non-severe and severe diabetic foot groups by using the Wagner classification method.Meanwhile to compare the differences of pathogenic bacteria and drug susceptibility characteristics between each group and analysis of mixed infection risk factors.Results:1.In this study,a total of 498 samples were collected,364 cases(73.1%)of which pathogenic microorganisms were cultured.A total of 530 strains of pathogenic microorganisms were cultured,including 195 strains of G~+bacteria(36.8%),305strains of G~-bacteria(57.5%)and 30 strains of fungi(5.7%).In the non-severe group,178 strains of G~-bacteria(54.1%),132 strains of G~+bacteria(40.1%)and 19 strains of fungi(5.8%)were detected.In the severe group,127 strains of G~-bacteria(63.2%),63 strains of G~+bacteria(31.3%),and 11 strains of fungi(5.5%)were detected.The study showed that the patients with different degrees of diabetic foot infection were mainly infected with G~-bacteria,and the difference in the proportion of G~-bacteria between the two groups was statistically significant(P<0.05).2.Bacterial drug susceptibility test analysis:Staphylococcus aureus,group B streptococcus and Enterococcus faecalis were the main G~+bacteria in DFI patients,while the main G~-bacteria were Pseudomonas aeruginosa,Proteus singularis,Bacillus pneumoniae and Acinetobacter baumannii(AB)bacteria.G~+bacteria were highly sensitive to vancomycin,linezolid,ceftriaxone,datoromycin and ticacycline,and had high resistance to tetracycline,erythromycin and clindamycin.G~-bacteria were more sensitive to imipenem,meropenem,levofloxacin,polymyxin B and piperacillin/tazobactam,and showed high resistance to cotrimoxazole,cefotaxime and cefuroxime.3.Analysis of mixed infection risk factors:Albumin level and history of antimicrobial agents were correlated with mixed infection(P<0.05).The independent risk factor of DFI patients with mixed infection was a history of antimicrobial agents,while the high level of albumin was a independent protective factors.Conclusions:1.The DFI in the region was mainly infected with G~-bacteria,and the proportion of G~-bacteria was higher in the severe group.The proportion of G~-bacteria in both groups was higher with Pseudomonas aeruginosa and Proteus anomalus.2.The top three detection rates of G~-bacteria were Pseudomonas aeruginosa,proteus strangus and bacillus pneumoniae,and G~-bacteria were more sensitive to imipenem,meropenem,levofloxacin,polymyxin B and piperacillin/tazobactam,and showed high resistance to cotrimoxazole,cefotaxime and cefuroxime.The above sensitive drugs should be the first choice for DFI patients in the region.3.The top three detection rates of G~+bacteria were Staphylococcus aureus,Enterococcus faecalis and Group B streptococcus,and G~+bacteria were highly sensitive to vancomycin,linezolid,ceftriaxone,datoromycin and ticacycline,and had high resistance to tetracycline,erythromycin and clindamycin.4.An independent risk factor for DFI patients with mixed infection was a history of antimicrobial agents,while high albumin level was an independent protective factor.