河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (9): 1041-1046.doi: 10.3969/j.issn.1007-3205.2024.09.010

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165例糖尿病足MDRO感染患者病原菌学及危险因素Logistic回归分析

  

  1. 河北省石家庄市人民医院检验科，河北 石家庄 050000

  • 出版日期:2024-09-25 发布日期:2024-10-09
  • 作者简介:吴丹（1985-），女，河北石家庄人，河北省石家庄市人民医院主管检验技师，医学学士，从事临床检验诊断研究。
  • 基金资助:
    河北省医学科学研究课题计划项目（20210825）

Pathogenic bacteria and Logistic regression analysis of risk factors in 165 patients with MDRO infection in patients with diabetic foot

  1. Department of Clinical Laboratory, People′s Hospital of Shijiazhuang City, Hebei Province, Shjiazhuang 050000, China

  • Online:2024-09-25 Published:2024-10-09

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摘要： 目的 分析165例糖尿病足多重耐药菌（multiple resistant bacteria，MDRO）感染患者病原菌学及危险因素。
方法 回顾性收集河北省石家庄市人民医院内分泌科收治的糖尿病足患者165例临床资料，根据患者是否发生MDRO感染将其分为感染组（49例）和未感染组（116例）。统计糖尿病足患者MDRO感染发生率及病原菌检出情况，采用多因素Logistic回归分析糖尿病足患者MDRO感染发生的危险因素。
结果 糖尿病足患者165例MDRO感染发生率为29.70%。165例糖尿病足患者共培养出感染病原菌132株，其中革兰阴性菌85株，占比64.39%；革兰阳性菌47株，占比35.61%。MDRO感染共88株，MDRO感染检出率为66.67%，其中主要MDRO感染病原菌种类为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌，占比分别为22.73%、18.18%、14.77%。多因素Logistic回归分析结果显示，合并骨髓炎、合并大血管病变、使用第三代头孢菌素、使用抗菌药物种类≥3种、有神经缺血性损伤、抗菌药物疗程≥5 d、Wanger分级3~5级均为糖尿病足患者MDRO感染的独立危险因素（OR=3.171、2.992、2.678、2.740、2.445、3.785、2.514，P＜0.05）。
结论 糖尿病足患者MDRO感染发生率较高，MDRO感染病原菌种类为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌，其主要与是否合并骨髓炎、是否合并大血管病变、是否使用第三代头孢菌素、使用抗菌药物种类、有无神经缺血性损伤、是否抗菌药物疗程、Wanger分级情况有关。


关键词: 糖尿病足, 多重耐药菌, 感染

Abstract: Objective To analyze the pathogenic bacteria and risk factors of multi-drug resistant bacteria (MDRO) infection in 165 patients with diabetic foot. 
Methods Clinical of 165 patients with diabetic foot who were admitted to the Department of Endocrinology of People′s Hospital of Shijiazhuang City were retrospectively analyzed. They were divided into the infection group (n=49) and the non-infection group (n=116) according to presence of MDRO infection. The incidence of MDRO infection and the detection of pathogenic bacteria in patients with diabetic foot were calculated, and multivariate Logistic regression was used to analyze the risk factors for MDRO infection in patients with diabetic foot. 
Results The incidence of MDRO infection in 165 patients with diabetic foot was 29.70%. A total of 132 infectious pathogens were cultured from 165 patients with diabetic foot, including 85 Gram-negative bacteria, accounting for 64.39% and 47 Gram-positive bacteria, accounting for 35.61%. A total of 88 strains of MDRO infection were detected, and the detection rate of MDRO infection was 66.67%. Among them, the main pathogenic bacteria of MDRO infection were Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, accounting for 22.73%, 18.18% and 14.77%, respectively. Multivariate Logistic regression analysis showed that the combination with osteomyelitis, combination with macroangiopathy, use of third-generation cephalosporins, use of ≥3 antimicrobial agents, presence of neuroischemic injury, duration of antimicrobial treatment ≥5 d, and Wanger grades 3-5 were all the independent risk factors for MDRO infection in patients with diabetic foot (OR=3.171, 2.992, 2.678, 2.740, 2.445, 3.785, 2.514, P＜0.05). 
Conclusion The incidence rate of MDRO infection in patients with diabetic foot is high. The pathogenic bacteria of MDRO infection include Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, which are mainly related to presence of combined osteomyelitis, combined macroangiopathy, use of the third-generation cephalosporins, the types of antibacterial drugs used, neuroischemic injury detected, the antibacterial drug treatment course adopted, and Wanger grade. 


Key words: diabetic foot, multi-resistant bacteria, infection

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