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首页> 外文期刊>International journal of infectious diseases : >Influence of multidrug resistant organisms on the outcome of diabetic foot infection
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Influence of multidrug resistant organisms on the outcome of diabetic foot infection

机译：多药耐药菌对糖尿病足感染结局的影响

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Objectives We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms. Methods We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. Results In total, 791 patients with DFI were included, 531(67%) were male, median age was 62 (19–90). Severe infection was diagnosed in 85 (11%) patients. Osteomyelitis was diagnosed in 291(36.8%) patients. 536 microorganisms were isolated, the most common microorganisms were S. aureus (20%), P. aeruginosa (19%) and E. coli (12%). Methicillin resistance (MR) rate among Staphylococcus aureus isolates was 31%. Multidrug resistant bacteria were detected in 21% of P. aeruginosa isolates. ESBL (+) Gram negative bacteria (GNB) was detected in 38% of E. coli and Klebsiella isolates. Sixty three patients (8%) were re-hospitalized. Of the 791 patiens, 127 (16%) had major amputation, and 24 (3%) patients died. In multivariate analysis, significant predictors for fatality were; dialysis (OR: 8.3, CI: 1.82–38.15, p = 0.006), isolation of Klebsiella spp. (OR:7.7, CI: 1.24–47.96, p = 0.028), and chronic heart failure (OR: 3, CI: 1.01–9.04, p = 0.05). MR Staphylococcus was detected in 21% of the rehospitalized patients, as the most common microorganism (p Conclusion Among rehospitalized patients, methicillin resistant Staphylococcus infections was detected as the most common agent, and Klebsiella spp. infections were found to be significantly associated with fatality.
机译：目的我们描述了患有多药耐药菌的足部感染的糖尿病患者的临床结局。方法我们纳入了2011年5月至2015年12月之间来自19个中心的糖尿病足感染（DFI）患者。根据IDSA DFI指南对感染进行了定义。严重感染，中度复杂感染患者应住院治疗。出院后对患者进行了6个月的随访。结果总共纳入791例DFI患者，其中531例（67％）为男性，中位年龄为62岁（19-90岁）。在85（11％）位患者中诊断出严重感染。 291名（36.8％）患者被诊断出骨髓炎。分离出536种微生物，最常见的微生物是金黄色葡萄球菌（20％），铜绿假单胞菌（19％）和大肠杆菌（12％）。金黄色葡萄球菌分离株的耐甲氧西林（MR）率为31％。在21％的铜绿假单胞菌分离物中检测到多药耐药细菌。在38％的大肠杆菌和克雷伯菌分离物中检测到ESBL（+）革兰氏阴性细菌（GNB）。六十三名患者（8％）被重新住院。在791名患者中，有127名（16％）截肢，死亡24名（3％）。在多变量分析中，死亡的重要预测因子是;透析（OR：8.3，CI：1.82–38.15，p = 0.006），分离克雷伯菌属。 （OR：7.7，CI：1.24-47.96，p = 0.028）和慢性心力衰竭（OR：3，CI：1.01-9.04，p = 0.05）。在再住院的患者中，最常见的微生物是MR葡萄球菌（21％）（p结论在再住院的患者中，耐甲氧西林的葡萄球菌感染是最常见的病原体，而Klebsiella spp。感染与死亡率显着相关。

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