Microbiological profile and clinical characteristics of diabetic foot infection in northern China: a retrospective multicentre survey in the Beijing area

J Med Microbiol. 2018 Feb;67(2):160-168. doi: 10.1099/jmm.0.000658. Epub 2018 Jan 2.

Abstract

Purpose: We aimed to define the microbiological characteristics of diabetic foot infection in patients in the Beijing area and to explore the demographic and clinical factors correlated with pathogen distribution.

Methodology: As part of a retrospective multicentre surveillance program conducted in eight hospitals in Beijing 2010-2014, we recruited all inpatients for whom bacterial culture had been performed. Demographic, clinical, laboratory and surgery data were obtained from medical records. Statistical analysis was performed to analyse data on microbiological and clinical characteristics.Results/Key findings. A total of 456 cases were included. The culture positivity was 95.4 %. Among all patients with positive cultures, 88 cases (20.2 %) had polymicrobial infections. Five hundred and fifty-one species were isolated from all specimens, including 39.6 % Gram-positive bacteria and 57.5 % Gram-negative bacteria. Enterobacteriaceae accounted for 41.0 % of all isolates. Staphylococcus aureus (17.1 %), Pseudomonas aeruginosa (13.1 %), Proteus spp. (9.8 %), Escherichia coli (9.3 %) and coagulase-negative Staphylococcus (8.3 %) were the most frequently isolated species. The rate of resistance to methicillin was 24.5 % for S. aureus. The susceptibility of P. aeruginosa to all antibiotics was over 60 %. The rate of extended-spectrum β-lactamase production among E. coli was 52.6 %. P. aeruginosa and Enterobacteriaceae show high sensitivity to piperacillin/tazobactam, carbapenems and amikacin. Multivariate analysis showed that patient age >60 years was independently associated with Gram-negative rods.

Conclusions: Enterobacteriaceae were the most frequently isolated organisms in our area. Older patients were more likely to suffer from Gram-negative rod infections. Gram-negative rods show high sensitivity to piperacillin/tazobactam, carbapenems and amikacin.

Keywords: Gram negative rods; diabetic foot infection; microbiology.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / microbiology*
  • Carbapenems / pharmacology
  • Carbapenems / therapeutic use
  • China
  • Diabetic Foot / diagnosis
  • Diabetic Foot / drug therapy
  • Diabetic Foot / microbiology*
  • Enterobacteriaceae / classification
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / isolation & purification*
  • Female
  • Gram-Negative Bacteria / classification
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Positive Bacteria / classification
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification*
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Tertiary Care Centers

Substances

  • Anti-Bacterial Agents
  • Carbapenems