老年糖尿病足MDROs感染病原菌及危险因素

Pathogenic bacteria and risk factors analysis of MDROs infection in elderly patients with diabetic feet

目的分析老年糖尿病足多药耐药菌(MDROs)感染的菌群分布及危险因素。方法2018年6月-2022年1月运城市盐湖区人民医院收治的老年糖尿病足感染患者202例纳入研究,根据MDROs感染情况纳入MDROs感染组(n=87)、非MDROs感染组(n=115),回顾性收集患者临床资料。分析老年糖尿病足MDROs感染的菌群分布,通过单因素、多因素分析老年糖尿病足MDROs感染的危险因素。结果202例老年糖尿病足感染患者发生MDROs感染87例,发生率为43.07%,共分离病原菌99株,以革兰阴性菌为主,其中占比前三的病原菌为金黄色葡萄球菌(33.33%)、大肠埃希菌(21.21%)、奇异变形杆菌(16.16%);多因素Logistic分析结果显示,合并骨髓炎、长期用抗菌药物、神经缺血性伤口、糖化血红蛋白(HbA1c)≥7%为老年糖尿病足MDROs感染的危险因素(P<0.05)。结论老年糖尿病足MDROs感染发生率为43.07%,以革兰阴性菌为主,多种因素与老年糖尿病足MDROs感染的发生有关,可对高危患者进行预防性干预。

OBJECTIVE To analyze the bacterial flora distribution and risk factors for multidrug-resistant organisms(MDROs)infection in elderly patients with diabetic foot.METHODS A total of 202 elderly patients with diabetic foot infection admitted to the People′s Hospital of Yanhu District in Yuncheng City from Jun 2018 to Jan 2022 were included in the study.According to whether MDROs infection occurred,patients were divided into the MDROs infection group(n=87)and non-MDROS infection group(n=115),and clinical data of these patients were retrospectively collected.The bacterial community distribution of MDROs in elderly diabetic feet infection was analyzed,the risk factors for elderly diabetic feet MDROs infection were analyzed by univariate and multivariate analysis.RESULTS There were 87 cases of MDROs infection in 202 elderly patients with diabetic foot infection,with an incidence of 43.07%.A total of 99 strains of pathogenic bacteria were isolated,mainly gram-negative bacteria,among which the top three pathogens were Staphylococcus aureus(33.33%),Escherichia coli(21.21%)and Proteus mirmirum(16.16%).Multivariate logistic analysis showed that osteomyelitis,long-term use of antibiotics,ischemic nerve wound,glycated hemoglobin(HbA1c)≥7% were the risk factors for elderly diabetic feet MDROs infection(P<0.05).CONCLUSION The incidence of MDROs infection in elderly diabetic feet was 43.07%,and the main strains were gram-negative bacteria.Many factors were related to the occurrence of MDROs infection in elderly diabetic feet,and preventive intervention could be carried out for high-risk patients.