Abstract:

Objective To study the distribution and drug resistance of pathogenic bacteria isolated from infectious patients with diabetic foot,and to provide a reference for using antibiotics rationally. Methods A retrospective study was carried out on the pathogenic bacterium identification and drug resistance isolated from the foot ulcers of 267 patients with diabetic foot. Results Among the 267 patients with diabetic foot,292 isolates of pathogenic bacteria were isolated from foot ulcers in 216 patients,and the positive rate was 80.9%（216/267）. There were 160（54.8%） isolates of Gram-negative bacilli,128（43.8%） isolates of Gram-positive cocci and 4（1.4%） isolates of fungi. Mixed infection was found in 46（17.2%） patients. Among the 160 isolates of Gram-negative bacilli,Proteus mirabilis,Escherichia coli,Enterobacter cloacae and Klebsiella pneumoniae were prevalent. Among the 128 isolates of Gram-positive cocci,Staphylococcus aureus,Enterococcus faecalis and Staphylococcus epidermidis were prevalent. Drug susceptibility test showed that carbapenems（imipenem,meropenem and ertapenem）,amikacin,cefepime and beta lactamase inhibitor were the most effective drugs against Gram-negative bacilli,and the drug resistance rates to ampicillin,piperacillin and aztreonam were high. Gram-positive cocci were sensitive to vancomycin,teicoplanin,linezolid,moxifloxacin and rifampicin,and the drug resistance rates to penicillin,erythromycin,clindamycin and tetracycline were high. Methicillin-resistant Staphylococcus aureus accounted for 32.7%（17/52） of Staphylococcus aureus. Escherichia coli and extended-spectrum beta-lactamases（ESBLs）-producing Klebsiella pneumoniae accounted for 44.4%（16/36） and 43.5%（10/23）. Conclusions The distribution of pathogenic bacteria causing diabetic foot infection is widespread. Gram-negative bacilli are the main pathogenic bacteria compared with Gram-positive cocci. A certain proportion of pathogenic bacteria are multi-drug resistant bacteria. Attention should be paid to the pathogenic bacteria and drug susceptibility test in diabetic foot infection patients. The key to the treatment of diabetic foot infection is early application of sensitive antibiotics.

Key words: Diabetic foot, Infection, Pathogenic bacterium, Drug resistance