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