糖尿病足患者多药耐药菌感染的危险因素logistic回归分析

Logistic regression analysis on risk factors of multi-drug resistant bacteria infection in diabetic foot disease

目的探讨糖尿病足患者多药耐药菌感染的危险因素,为制定临床防治措施提供理论依据。方法回顾性分析医院2014年1月-2016年6月收治192例糖尿病足患者的临床资料,分析多药耐药菌的分布情况,对比患者的各项临床资料,并通过多因素logistic回归分析,探讨糖尿病足患者多药耐药菌感染的危险因素。结果 61例患者发生多药耐药菌感染,感染率为31.77%;93株多药耐药菌中,检出金黄色葡萄球菌41株(44.09%),检出铜绿假单胞菌20株(21.51%);使用抗菌药物、第三代头孢菌素类抗菌药物、有神经缺血性伤口、同一溃疡面住院>2次、发生骨髓炎的多药耐药感染率均显著高于无使用抗菌药物、无使用第三代头孢菌素类抗菌药物、无神经缺血性伤口、同一溃疡面住院≤2次、未发生骨髓炎的多药耐药感染率,差异有统计学意义(P<0.05);多因素logistic回归分析显示,使用抗菌药物、有神经缺血性伤口、同一溃疡面住院>2次以及骨髓炎是糖尿病足患者多药耐药菌感染的危险因素(P<0.05)。结论糖尿病足发生多药耐药菌感染的风险较高,临床应针对发生多药耐药菌感染的危险因素,制定有效的防治措施,以提高疾病的诊疗效果,改善患者预后。

OBJECTIVE To investigate the risk factors of multi-drug resistant bacteria infection in diabetic foot disease,so as to provide theoretical basis for the development of prevention and treatment measures.METHODS The clinical data of 192 cases of patients with diabetic foot from Jan.2014 to Jun.2016 were retrospectively analyzed.The distribution of multi-drug resistant bacteria was analyzed,the clinical data of the two groups of patients were compared,and through the multivariate logistic regression analysis,the risk factors of multi-drug resistant bacteria infection in diabetic foot were explored.RESULTS In this study,61 cases had multi-drug resistant bacteria infection,and the infection rate was 31.77%.In 93 strains of multi-drug resistant bacteria,41 strains of Staphylococcus aureus（44.09%）and 20 strains of Pseudomonas aeruginosa（21.51%）were detected.The multi-drug resistant infection rates of the patients with the use of antibiotics,the third generation of cephalosporins,nerve ischemic wound,hospitalization for the same ulcer surface 2times,and osteomyelitis were significantly higher than those of no use of antibiotics,no use of the third generation cephalosporins,no nerve ischemic wound,hospitalization for the same ulcer surface less than or equal to 2times,and no osteomyelitis,and the difference was statistically significant（P〈0.05）.The multivariate logistic regression analysis showed that the use of antibiotics,nerve ischemic wound,hospitalization for the same ulcer surface more than 2times and the osteomyelitis were risk factors of multi-drug resistant bacteria infection of diabetic foot（P〈0.05）.CONCLUSION Diabetic foot had a higher risk of multi-drug resistant bacteria infection.It should develop effective prevention and control measures,according to risk factors for multi-drug resistant bacteria infection in clinic,in order to improve the diagnosis and treatment of the disease,and improve the prognosis of patients.