Investigation And Analysis Of Wound Bacteriology And Infection Factors In Patients With Diabetic Foot

ObjectiveTo find the general clinical status of patients with diabetic foot wound secretions and bacteriological characteristics,and analysis the factors of affecting wound in patients with diabetic foot infection.To provide reference for effective prevention and treatment of infection and rational use of antibiotics.Methods1.Retrospectively analyzed the diabetic foot patients from January 2013 to December 2016 of burn plastic surgical department of Tianjin first central hospital.Collected the patient's relevant clinical datas.2.Investigated the microbial identification and drug sensitivity test results ofeach patient after admission,and analysed the related factors of wound infection.3.Statistics and data were processed using the SPSS21.0 software,count data expressed by rate,measurement data were showed by(?±s),and the correlation degree is represented by r.Logistic was used to analyze the risk factors of infection,P<0.05 was considered statistically significant.Results1.There were 103 cases of diabetic foot patients in this study,a total of 194 specimens were collected.,there were 167 cases of pathogenic bacteria,the detection rate was 86.1%.A total of 173 strains were obtained,and 78 strains of gram positive bacteria accounted for 45.1%,92 strains of gram negative bacteria accounted for 53.2%.The most common gram positive bacteria were Staphylococcus aureus,accounting for 39.7%,followed by Staphylococcus epidermidis,accounting for 25.6%.Gram negative bacteria were the most common Pseudomonas aeruginosa,accounting for 27.2%,followed by Bauman Acinetobacter,accounting for 17.4%.2.The susceptibility rates of Staphylococcus aureus to vancomycin and linezolid were 100% and 83.9%,respectively.The susceptibility of Staphylococcus epidermidis to vancomycin and linezolid was about 100% and 85.0%,respectively.The susceptibility rates of Pseudomonas aeruginosa were 72.0% and 84.0% for imipenem and meropenem;Bauman Acinetobacter to Amikacin,imipenem and meropenem were 75.0%,81.3% and 81.3%3.Diabetic foot wound infection may be the influencing factors Logistic regression analysis showed that hypoalbuminemia(OR=6.172,P=0.001),lower extremity vascular disease(OR=3.741,P=0.004),diabetic nephropathy(OR=2.685,P= 0.002),diabetes(OR=2.324,P=0.004 increased)and glycosylated hemoglobin(OR= 1.216,P=0.005)were influencing factors of diabetic foot wound infection.Conclusions1.103 cases of patients with diabetic foot wound pathogen detection rate was 86.1%.The top 4 pathogens were Staphylococcus aureus,Pseudomonas aeruginosa,Staphylococcus epidermidis and Bauman Acinetobacter.Gram-positive bacteria accounted for 45.1%,the first pathogens were Staphylococcus aureus,followed by Staphylococcus epidermidis.And gram-negative bacteria accounted for 53.2%.The first one was Pseudomonas aeruginosa and followed by Acinetobacter baumannii.2.Staphylococcus aureus were highly sensitive to vancomycin and linezolid,Staphylococcus were highly sensitive to epidermidis and tigecycline.Pseudomonas aeruginosa were sensitive to imipenem and meropenem;Baumannii were sensitive to Amikacin,imipenem and meropenem.3.Influence factors of diabetic foot wound infection were hypoproteinemia,lower extremity vascular disease,diabetic nephropathy,diabetes duration and glycated hemoglobin.