Changes Of Bacterial Infection And Drug Treatment In Patients With Diabetic Foot Osteomyelitis

Objectives:To investigate the changes of pathogenic bacteria distribution,antibiotic sensitivity and drug resistance in patients with diabetic foot osteomyelitis..Methods:The clinical data of 267 patients with diabetic foot osteomyelitis in the Department of Endocrinology of Handan Central Hospital from January 1,2012 to December 31,2017 were selected and divided into three groups according to time to explore the distribution of pathogenic bacteria and changes in drug sensitivity in patients with diabetic foot osteomyelitis.Results:(1)From 2012 to 2017,the number of diabetic foot osteomyelitis patients gradually increased.Among the pathogenic bacteria,gram-positive bacteria infection accounted for 43.71% and showed a downward trend.Staphylococcus aureus,coagulase negative staphylococcus and streptococcus were the most common,all of which were100% sensitive to vancomycin,tekola and linezolid,but no drug-resistant strain.The sensitivity rate to moxifloxacin was higher and the drug resistance rate was lower.(2)Gram-negative bacteria accounted for 51.80% and showed an upward trend.Pseudomonas aeruginosa,proteobacterium and escherichia coli were the most common bacteria,with high sensitivity and low drug resistance to imipenem,meropyrine,cefepime and β-lactamase inhibitors.(3)Gram-positive bacteria and gram-negative bacteria showed decreased antibacterial activity against common antibacterial agents.(4)Fungal infection accounted for 4.49% and showed an increasing trend.Some strains were resistant to itraconazole to varying degrees.Conclusions:(1)The number of diabetic foot osteomyelitis patients is increasing year by year.Gram-negative bacteria are the main pathogens,and fungal infections are on the rise.(2)It is suggested that antibiotics covering G-,G+ bacteria should be selected as the starting treatment,and more emphasis should be placed on G-bacteria.Antibiotics with strong effect and high sensitivity should be used.Glycopeptides and fluoroquinolones should be preferred for Gram-positive bacteria,and third and fourth generation cephalosporins,beta-lactamase inhibitors and fluoroquinolones should be preferred for Gram-negative bacteria.(3)Continuous detection of bacterial culture and drug susceptibility results can guide the early empirical use of antibiotics.