Analysis Of Related Factors Of Distribution And Clinical Prognosis Of Diabetic Foot Pathogens In Yulin City

Objective:To analyze the distribution of pathogenic bacteria,drug sensitivity results,characteristics of bacterial spectrum change,the risk factors of amputation/toe and recurrence in diabetic foot patients in Yulin city,in order to guide the treatment of diabetic foot and improve clinical prognosis.method:A retrospective analysis was performed in 212 cases of diabetic foot patients from July 2011 to July 2018 in the third-grade class-A hospital of Yulin City.All patients underwent foot secretion pathogen culture and drug sensitivity test.The characteristics of pathogen spectrum change in diabetic foot patients in recent 8 years were analyzed,and the clinical prognosis of patients with and without amputation/toe and recurrence of diabetic foot were tracked and followed up,and the related risk factors of clinical prognosis of diabetic foot were analyzed by binary Logistic regression.result:1.212 strains of bacteria has been isolated from diabetic foot wound secretians,among which 147 were positive,195 bacterial strains and 6 fungal strains,mainly including staphylococcus aureus,dung,e.coli and acinetobacter baumannii,of which117 strains gram-positive bacteria,including staphylococcus aureus,32 strains(16.4%),25 in enterococcus strains(12.8%),72 strains of gram-negative bacteria,including 19 strains of e.coli(9.7%),16 strains of acinetobacter baumannii(8.2%).2.Drug sensitive test results: staphylococcus aureus to penicillin sensitivity was93.8%,sensitivity to clindamycin was 81.3%,sensitivity to erythromycin in enterococcuswas 68.0%,sensitivity to levofloxacin,penicillin was 48.0%,e.coli bacterium to ampicillin,cefoperazone shu ba jotham sensitivity is 89.5%,bowman’s acinetobacter to ampicillin-shu ba,and piperacillin he azole sensitivity is 87.5%.3.Characteristics of changes in the pathogen spectrum of diabetic foot: In the past 8years,the pathogen spectrum of patients with diabetic foot in Yulin area showed a downward trend of Gram-positive bacteria,and Gram-negative bacteria showed an upward trend.4.Analysis of related risk factors for clinical prognosis of diabetic foot: significantly increased white blood cell count and glycosylated hemoglobin,combined with severe lower limb vascular disease,diabetic peripheral neuropathy,hypertension and gram-negative bacteria are risk factors for diabetic foot amputation/toe;Multiple drug resistance,the course of diabetic foot over 60 days,low hemoglobin and gram-positive bacterial infection are risk factors for recurrence of diabetic foot.Conclusion:1.Staphylococcus aureus,enterococcus faecalis,escherichia coli and acinetobacter baumannii are common diabetic foot pathogens.2.Staphylococcus aureus is sensitive to clindamycin and penicillin,enterococcus faecalis is sensitive to penicillin,erythromycin and levofloxacin,escherichia coli is sensitive to cefoperazone sulbactam and ampicillin,and acinetobacter baumannii is sensitive to ampicillin sulbactam and piperacillin tazobactam.3.The incidence of diabetic foot caused by Gram-negative bacteria infection is on the rise.4.Controlling blood sugar and blood pressure,delay the progression of diabetic lower limb vascular disease and peripheral neuropathy,and active and effective anti-infection treatment can reduce the risk of diabetic foot amputation/toe;Reasonable use of antibiotics,improvement of anemia and shortening of the course of diabetic foot can effectively avoid the recurrence of diabetic foot,thus reducing the death and disability rate of diabetic foot and improving the prognosis of diabetic foot.