Distribution and antimicrobial resistance in 277 cases with diabetic foot infection

Objective To analyze the distribution and antimicrobial resistance in diabetic foot infection. Methods A cross-section survey was conducted on 277 patients with diabetic foot infection admitted in our hospital between January 2020 and January 2023. Their clinical data were collected, and wound characteristics, pathogenic bacteria and drug resistance were analyzed statistically for the distribution of pathogenic bacteria, drug resistance rate, and risk factors for multidrug-resistant bacterial infections. Results There were 228 strains of pathogenic microorganisms isolated from the 277 patients, including 104 strains of Gram-positive bacteria, 115 strains of Gram-negative bacteria, 7 strains of fungi, and 2 strains of actinomycetes. The proportion of Gram-negative bacteria was significantly larger in the patients with Wagner grade >3 and course of ulcers >30 d. The isolated Gram-positive bacteria were highly resistant to penicillin and erythromycin, and most of them were sensitive to vancomycin and linezolid. While the Gram-negative ones were highly resistant to the third- and fourth-generation cephalosporins, and most sensitive to carbapenems. Wagner grade >3 and course of ulcers >30 d were independent risk factors for infection of multidrug-resistant organisms. Conclusion There is heterogeneity in the distribution of pathogenic microorganisms in diabetic foot infection. For the patients with Wagner grade >3 and course of ulcers >30 d, they have higher rate of Gram-negative bacterial infection, and are at higher risk of multidrug-resistant bacterial infection, so timely and targeted adjustment should be implemented for their treatment regimens.