Comparison of bacterial species and clinical outcomes in patients with diabetic hand infection in tropical and nontropical regions

作者全名：Chen, Yan; Liu, Bin; Chen, Huan; Xie, Puguang; Du, Chenzhen; Rui, Shunli; Mei, Hao; Duan, Zixiao; Armstrong, David G.; Deng, Wuquan; Xiao, Xiaoqiu

作者地址：[Chen, Yan; Xiao, Xiaoqiu] Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Translat Med Major Metab Dis, Chongqing 400010, Peoples R China; [Chen, Yan; Xie, Puguang; Du, Chenzhen; Rui, Shunli; Duan, Zixiao; Deng, Wuquan] Chongqing Univ, Cent Hosp, Chongqing Emergency Med Ctr, Dept Endocrinol, Chongqing 400014, Peoples R China; [Liu, Bin] Chongqing Univ, Chongqing Emergency Med Ctr, Cent Hosp, Dept Emergency, Chongqing 400014, Peoples R China; [Chen, Huan] Bazhong City Cent Hosp, Geriatr Med Ctr, Bazhong 636600, Peoples R China; [Mei, Hao] Renmin Univ China, Ctr Appl Stat, Sch Stat, Beijing 100872, Peoples R China; [Armstrong, David G.] Univ Southern Calif, Keck Sch Med, Dept Surg, Los Angeles, CA 90033 USA

通信作者：Xiao, XQ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Translat Med Major Metab Dis, Chongqing 400010, Peoples R China.; Deng, WQ (通讯作者)，Chongqing Univ, Cent Hosp, Chongqing Emergency Med Ctr, Dept Endocrinol, Chongqing 400014, Peoples R China.

来源：ARCHIVES OF DERMATOLOGICAL RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001225933200003

JCR分区：Q3

影响因子：1.8

年份：2024

卷号：316

期号：5

开始页：　

结束页：　

文献类型：Article

关键词：Bacterial distribution; Diabetic hand; Tropical regions; Nontropical regions

摘要：Hand infection is a rare complication in patients with diabetes. Its clinical outcomes depend on the severity of hand infection caused by bacteria, but the difference in bacterial species in the regional disparity is unknown. The purpose of this study was to explore the influence of tropical and nontropical regions on bacterial species and clinical outcomes for diabetic hand. A systematic literature review was conducted using PubMed, EMBASE, Web of Science, and Google Scholar. Moreover, the bacterial species and clinical outcomes were analyzed with respect to multicenter wound care in China (nontropical regions). Both mixed bacteria (31.2% vs. 16.6%, p = 0.014) and fungi (7.5% vs. 0.8%, p = 0.017) in the nontropical region were significantly more prevalent than those in the tropical region. Staphylococcus and Streptococcus spp. were dominant in gram-positive bacteria, and Klebsiella, Escherichia coli, Proteus and Pseudomonas in gram-negative bacteria occupied the next majority in the two regions. The rate of surgical treatment in the patients was 31.2% in the nontropical region, which was significantly higher than the 11.4% in the tropical region (p = 0.001). Although the overall mortality was not significantly different, there was a tendency to be increased in tropical regions (6.3%) compared with nontropical regions (0.9%). However, amputation (32.9% vs. 31.3%, p = 0.762) and disability (6.3% vs. 12.2%, p = 0.138) were not significantly different between the two regions. Similar numbers of cases were reported, and the most common bacteria were similar in tropical and nontropical regions in patients with diabetic hand. There were more species of bacteria in the nontropical region, and their distribution was basically similar, except for fungi, which had differences between the two regions. The present study also showed that surgical treatment and mortality were inversely correlated because delays in debridement and surgery can deteriorate deep infections, eventually leading to amputation and even death.

基金机构：National Natural Science Foundation of China [82370903]; Joint Medical Research Key Programs of Chongqing Science and Technology Bureau and Health Commission Foundation [2023ZDXM009]; National Institutes of Health; National Institute of Diabetes and Digestive and Kidney Diseases [1R01124789-01A1]; National Science Foundation (NSF) Center to Stream Healthcare [C2SHiP, 2052578]

基金资助正文：This study was supported by the National Natural Science Foundation of China (Grant No. 82370903) and the Joint Medical Research Key Programs of Chongqing Science and Technology Bureau and Health Commission Foundation (No. 2023ZDXM009) awarded to Dr. Wuquan Deng. This study is also partially supported by the National Institutes of Health, the National Institute of Diabetes and Digestive and Kidney Diseases (1R01124789-01A1) and the National Science Foundation (NSF) Center to Stream Healthcare in Place (#C2SHiP) CNS (2052578) awarded to Prof. Armstrong DG.