Bacterial distribution, changes of drug susceptibility and clinical characteristics in patients with diabetic foot infection

Exp Ther Med. 2018 Oct;16(4):3094-3098. doi: 10.3892/etm.2018.6530. Epub 2018 Jul 26.

Abstract

The present study aimed to investigate the bacterial distribution, changes in drug susceptibility and clinical characteristics in patients with diabetic foot infection (DFI). A retrospective analysis of 216 patients with DFI treated at Xinxiang Central Hospital between 2013 and 2016 was carried out to analyze the bacterial distribution, changes of susceptibility and clinical characteristics. A total of 262 pathogenic strains were isolated from 216 patients with DFI. Among them, 43.13% exhibited Gram-positive (G+) bacteria, 45.04% exhibited Gram-negative (G-) bacteria and 11.83% was other. Between 2013 and 2016, the susceptibility of pathogenic bacteria to common antibacterial drugs showed a declining trend year by year. G+ bacteria had high susceptibility to vancomycin and acetazolamide; while G- bacteria showed high susceptibility to dibekacin, panipenem and biapenem. The main clinical symptoms of the 216 patients included edema (98.61%), purulent secretions (62.96%) and lower extremity sepsis (58.80%). The top three complications of the 216 cases were lower extremity vascular disease (58.80%), peripheral neuropathy (39.81%) and kidney disease (26.39%). Logistic regression analysis showed that age [odds ratio (OR), 2.708; P=0.005], previous use of antibacterial drugs (OR, 3.816; P=0.007) and application of the third generation cephalosporins (OR, 3.014; P=0.008) were the independent risk factors of drug resistance in patients with DFI (P<0.05). There were numerous types of pathogens in patients with DFI, and all of them had certain drug resistance. The drug susceptibility was decreasing year by year. The pathogens and drug resistance in patients with DFI should be monitored to reduce the incidence of related complications and improve the prognosis of patients.

Keywords: diabetic foot infection; drug susceptibility; pathogens.