BackgroundTo investigate the distribution of microbes and drug susceptibility in patients with diabetic foot infections (DFI) and provide guidance for clinical empirical treatment and the rational selection of antibacterial drugs.MethodsRetrospective analysis of the pathogenic bacterium distribution and antimicrobial susceptibility isolated from 581 DFI patients with different Wagner grades.ResultsThe 534 positive samples included 473 cases (88.58%)) of monomicrobial infections and 61 cases (11.42%) of polymicrobial infections before antibiotic therapy. A total of 656 strains were cultivated, including 387 (58.99%) strains of gram-positive organisms (GPOs), 235 (35.82%) gram-negative bacilli (GNB), and 21 (3.20%) fungal strains. Polymicrobial infections mainly occurred in patients with Wagner grade 3-4 ulcers. GPOs were predominant in Wagner grades 1-3 (grade 1: 96.67%, grade 2: 76.52%, grade 3 62.81%), and the most common was Staphylococcus aureus (grade 1: 31.66%, grade 2: 33.04%, grade 3 35.53%). GNB were predominant in grades 4-5 (grade 4: 51.46%, grade 5:60%), and the most common GNB in Wagner grades 4-5 was Proteus (grade 4:27.88%, grade 5: 42.86%), while the most common GPO was Enterococcus (grade 4:34.48%, grade 5:25.00%). Staphylococcus (including MRSA) and Enterococcus were still highly sensitive to vancomycin, linezolid, and tigecycline. Most GNB were still highly sensitive to meropenem, tigecycline, ertapenem, and amikacin. Proteus was most sensitive to amikacin (97.14%), followed by meropenem (92%) and ertapenem (80%).ConclusionThe distribution of microbes and antimicrobial susceptibility in DFI patients varied with different Wagner grades. The most appropriate antimicrobial therapy should be selected based on the pathogen culture and antimicrobial susceptibility.

中文翻译：

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华南地区糖尿病足感染患者微生物分布及药敏分析

背景为了解糖尿病足感染（DFI）患者的微生物分布及药敏情况，为临床经验性治疗和抗菌药物的合理选择提供指导。 Wagner分级结果534例阳性样本中抗生素治疗前473例（88.58%）单一微生物感染和61例（11.42%）多种微生物感染。共培养菌株656株，其中革兰阳性菌（GPOs）387株（58.99%），革兰阴性杆菌（GNB）235株（35.82%），真菌21株（3.20%）。多种微生物感染主要发生在 Wagner 3-4 级溃疡患者中。GPO以Wagner 1-3级为主（1级：96.67%，2级：76.52%，3级62.81%），最常见的是金黄色葡萄球菌（1级：31.66%，2级：33.04%，3级35.53%）。GNB 在 4-5 年级中占主导地位（4 年级：51.46%，5 年级：60%），Wagner 4-5 年级中最常见的 GNB 是变形杆菌（4 级：27.88%，5 级：42.86%），而最常见的 GPO 是肠球菌（4 级：34.48%，5 级：25.00%）。葡萄球菌（包括耐甲氧西林金黄色葡萄球菌）和肠球菌对万古霉素、利奈唑胺和替加环素仍高度敏感。大多数 GNB 仍然对美罗培南、替加环素、厄他培南和阿米卡星高度敏感。变形杆菌对阿米卡星最敏感（97.14%），其次是美罗培南（92%）和厄他培南（80%）。结论不同Wagner分级的DFI患者的微生物分布和药敏情况不同。应根据病原体培养和抗菌药物敏感性选择最合适的抗菌药物治疗。