糖尿病足溃疡感染多重耐药铜绿假单胞菌的危险因素及预后分析

Risk factors for multi-drug resistance pseudomonas aeruginosa infection and prognost is analysis in diabetic foot ulcer patients

目的探讨糖尿病足溃疡(DFU)感染多重耐药铜绿假单胞菌(MDRPA)的危险因素及其对预后的影响。方法将117例DFU感染铜绿假单胞菌(PA)患者根据是否感染MDRPA分为非MDRPA(N-MDRPA)组和MDRPA组,分析DFU感染MDRPA的危险因素及其对预后的影响。结果入院前抗生素应用史、入院前因同一溃疡住院史和骨髓炎是DFU患者感染MDRPA的独立危险因素。MDRPA组较N-MDRPA组截肢/趾率高(32.6%vs 16.2%,P<0.05),治愈率低(20.9%vs 41.9%,P<0.05)。结论入院前抗生素应用史、入院前因同一溃疡住院史和骨髓炎是DFU患者感染MDRPA的独立危险因素。MDRPA可导致创面预后差,增加截肢/趾风险。

Objective To determine the risk factors for diabetic foot ulcer （DFU） with multi-drug resistant Pseudomonas aeruginosa （MDRPA） and the effects of MDRPA to the prognosis of DFU. Methods 117 DFU patients who infected with Pseudomonas aeruginosa （PA） in hospital were divided into two groups according to the infection of MDRPA. And risk factors of DFU MDRPA infection and the effect of MDRPA to the prognosis of DFU were analyzed. Results Antibiotic therapy history before hospitalization, previous hospitalization for the same wound and osteomyelitis were independent risk factors for DFU with MDRPA infection. Compared with non-MDRPA group, MDRPA had a higher amputation/toe rate （32.6% vs 16.2%,P〈0.05）,lower cure rate （20.9% vs 41.9%,P〈0.05）. Conclusion Antibiotic therapy history before hospitalization, previous hospitalization for the same wound and osteomyelitis were independent risk factors for MDRPA DFU. MDRPA infection often leads to a poor prognosis,and increases the risk of amputation/toe in DFU patients.