Distribution and drug sensitivity of pathogenic bacteria in diabetic foot ulcer patients with necrotizing fasciitis at a diabetic foot center in China

作者全名："Li, Xuemei; Du, Zhipeng; Tang, Ziwei; Wen, Qin; Cheng, Qingfeng; Cui, Yunhua"

作者地址："[Li, Xuemei] Chongqing Hlth Ctr Women & Children, Dept Pharm, Chongqing, Peoples R China; [Li, Xuemei; Wen, Qin] Chongqing Med Univ, Dept Pharm, Affiliated Hosp 1, Chongqing, Peoples R China; [Du, Zhipeng; Tang, Ziwei; Cheng, Qingfeng] Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, 1 Yixueyuan Rd, Chongqing 400016, Peoples R China; [Wen, Qin] Chongqing Yunyang Cty Tradit Chinese Med Hosp, Dept Pharm, Chongqing, Peoples R China; [Cui, Yunhua] Hubei Univ Arts & Sci, Xiangyang Cent Hosp, Dept Resp & Criti Cal Care Med, 136 Jingzhou St, Xiangyang 441021, Hubei, Peoples R China"

通信作者："Cheng, QF (通讯作者)，Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, 1 Yixueyuan Rd, Chongqing 400016, Peoples R China.; Cui, YH (通讯作者)，Hubei Univ Arts & Sci, Xiangyang Cent Hosp, Dept Resp & Criti Cal Care Med, 136 Jingzhou St, Xiangyang 441021, Hubei, Peoples R China."

来源：BMC INFECTIOUS DISEASES

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000785604900002

JCR分区：Q2

影响因子：3.7

年份：2022

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Necrotizing fasciitis; Diabetic foot ulcer; Pathogenic bacteria; Antimicrobial susceptibility test; Initial empirical antimicrobials

摘要："Background Diabetic foot ulcer is one of the major complications for patients with diabetes, and has become an important cause of non-traumatic amputation. Necrotizing fasciitis is a life-threatening soft-tissue infection involving the fascia and subcutaneous tissue. When diabetic foot ulcers are complicated by necrotizing fasciitis (DNF), this increases the risk for amputation and mortality, making DNF treatment more complicated, and eventually leading to amputation and mortality. However, studies on pathogenic bacteria's distribution and drug sensitivity in DNF patients remain lacking. This study investigated the distribution and susceptibility of pathogenic bacteria in DNF patients, and provided empirical antibacterial guidance for the clinic. Methods In a single diabetic foot center, the results from microbial cultures and drug susceptibility tests of patients with DNF from October 2013 to December 2020 were collected and analyzed. Results A total of 101 DNF patients were included in this study, of whom 94 had positive culture test results. A total of 124 pathogens were cultured, including 76 Gram-positive bacterial strains, 42 Gram-negative bacterial strains, and six fungal strains. Polymicrobial infections accounted for 26.7% and monomicrobial infections accounted for 66.3%. Staphylococcus aureus was the most common bacterium isolated, followed by Enterococcus faecalis and Streptococcus agalactiae. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Proteus mirabilis were the most common Gram-negative bacteria. Thirty-five strains of multi-drug resistant bacteria were isolated, representing 28.2% of the total isolates. Gram-positive bacteria were more sensitive to levofloxacin, moxifloxacin, vancomycin, teicoplanin, tigecycline, and linezolid, while Gram-negative bacteria were more sensitive to amikacin, piperacillin/tazobactam, cefoperazone/sulbactam, ceftazidime, cefepime, imipenem, and meropenem. Conclusions Gram-positive bacteria were the main bacteria isolated from DNF patients. The bacterial composition, the proportion of multi-drug resistant bacteria among the pathogens, and the high risk for amputation should be fully considered in the initial empirical medication, and broad-spectrum antibacterials are recommended."

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