Distribution of pathogens and risk factors of multidrugresistant organism infection in patients with diabetic foot ulcer

Abstract:

ObjectiveTo understand distribution of pathogens and risk factors of multidrugresistant organism (MDRO) infection in patients with diabetic foot ulcer(DFU), and provide reference for effective clinical prevention and treatment of MDRO infection in patients with DFU. MethodsPatients with DFU and admitted to department of endocrinology and department of orthopedics in a tertiary firstclass general hospital between January 2011 and September 2016 were surveyed. Occurrence of diabetic foot infection was surveyed retrospectively, risk factors for MDRO infection were analyzed by univariate and multivariate logistic regression analysis. ResultsA total of 135 patients with DFU were surveyed, 122 strains of pathogens were isolated, 75 (61.48%) of which were gramnegative bacteria, 42(34.43%) were grampositive bacteria, and 5(4.10%) were fungi. Among 117 isolated strains, 76 were MDRO strains (64.96%), 22.37% of which were Escherichia coli, 17.11% were Staphylococcus aureus, and 15.79% were Pseudomonas aeruginosa. Univariate analysis suggested that 7 risk factors for MDRO infection in patients with DFU were history of antimicrobial use, antimicrobial treatment course＞10 days, combined more than 2 kinds of antimicrobial use, No. of hospitalization＞2 times per year due to wound at the same site, combined with osteomyelitis, neuroischemic wound, and Wagner grade 3-5(P＜0.05）. Multivariate logistic analysis revealed that independent risk factors for MDRO infection in patients with DFU were history of antimicrobial use, antimicrobial treatment course＞10 days, No. of hospitalization＞2 times per year due to wound at the same site, combined with osteomyelitis, neuroischemic wound, and Wagner grade 3-5(P＜0.05）.ConclusionPrevention is the priority of MDRO infection in patients with DFU, monitoring of degree of focal infection and change in pathogens should be paid attention, antimicrobial agents should be used rationally according to susceptibility of pathogens, bacterial resistance needs to be reduced as much as possible.