Effects of common bacterial infections in patients with diabetic foot ulcer on clinical characteristics and short-term outcome

Abstract

Objective To analyze the effects of common infected bacteria on clinical characteristics and short-term outcomes of patients with diabetic foot ulcer(DFU). Methods A total of 720 patients with positive bacterial culture were selected from 1 025 cases of DFU. These patients were divided into five groups according to the 5 most common infected bacteria. The outcomes of healing, no-healing, amputation, and death were calculated 3 months after hospitalization. The clinical characteristics of these 5 bacterial groups and risk factors for outcome were analyzed. Results The 5 most common infected bacteria were staphylococcus aureus, pseudomonas aeruginosa, proteus, enterococcus faecalis, and escherichia coli, which included 405 among 720 positively cultured cases. Among these groups, there were no differences in clinical characteristics except for the foot ulcer. In staphylococcus aureus and pseudomonas aeruginosa infected groups, 55.0% and 71.1% patients were at Wagner 1-2 degree, while 77.5% and 84.2% patients were with mild to moderate infection. In proteus, enterococcus faecalis, and escherichia coli infected groups, 49.2%, 52.8%, and 63.2% patients were at Wagner 3-5 degree, respectively. The percentages of severe infected patients in enterococcus faecalis and escherichia coli groups were 38.2% and 42.1%, respectively. Healing rates of 3 months in staphylococcus aureus and pseudomonas aeruginosa groups were over 47%. In proteus, enterococcus faecalis, and escherichia coli groups, the healing rates were lower than 40%, with amputation rate over 40%(all P 9% were found to be the main risk factors for amputation and ulcers healing(P<0.05). Conclusions Clinical characteristics of DFU patients infected with different kinds of bacteria were manifested significantly different. The foot conditions of DFU patients infected with proteus, enterococcus faecalis, and escherichia coli were relatively more severe, and related with worse prognosis. (Chin J Endocrinol Metab, 2017, 33: 11-16) Key words: Diabetic foot ulcer; Bacterial infection; Wound healing; Amputation