دورية أكاديمية
The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection
| العنوان: | The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection |
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| المؤلفون: | Saltoglu, N., Surme, S., Ezirmik, E., Kadanali, A., Kurt, A.F., Sahin Ozdemir, M., Ak, O. |
| بيانات النشر: | SAGE Publications Inc. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | antimicrobial resistance, diabetic foot infection, major amputation, multidrug-resistant organisms, reinfection, aminoglycoside, amoxicillin plus clavulanic acid, beta lactam, beta lactamase inhibitor, C reactive protein, carbapenem, cephalosporin, clindamycin, cotrimoxazole, daptomycin, glycopeptide, linezolid, piperacillin plus tazobactam, quinolone derivative, sultamicillin, tigecycline, vancomycin, antiinfective agent, Acinetobacter baumannii, adult, aged, amputation, antibiotic resistance, antibiotic therapy, Article |
| الوصف: | We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 ± 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection (p =.043) and vancomycin treatment (p =.007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency (p =.004), hospital readmission (p =.009), C-reactive protein > 130?mg/dL (p =.007), and receiving carbapenems (p =.005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials. © The Author(s) 2021. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 15347346 |
| العلاقة: | International Journal of Lower Extremity Wounds; Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı; https://doi.org/10.1177/15347346211004141Test; https://hdl.handle.net/20.500.12831/17898Test; 22; 283; 290; 2-s2.0-85104645892 |
| DOI: | 10.1177/15347346211004141 |
| الإتاحة: | https://doi.org/10.1177/15347346211004141Test https://doi.org/20.500.12831/17898Test https://hdl.handle.net/20.500.12831/17898Test |
| حقوق: | info:eu-repo/semantics/closedAccess |
| رقم الانضمام: | edsbas.7926766C |
| قاعدة البيانات: | BASE |
| تدمد: | 15347346 |
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| DOI: | 10.1177/15347346211004141 |