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Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission
PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) may complicate the treatment of diabetic foot infections (DFIs). The aim of this study was to determine the risk factors for these pathogens in DFIs. MATERIAL AND METHODS...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedad Española de Quimioterapia
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712337/ https://www.ncbi.nlm.nih.gov/pubmed/33246358 http://dx.doi.org/10.37201/req/101.2020 |
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author | Zafra, Victoria García Torres, Alicia Hernández Vázquez, Elisa García Cogollos, Teresa Soria Jordana, Manuel Canteras Gómez, Joaquín Ruiz Gómez, Joaquín Gómez Martínez, Antonio Hernández Barberán, José |
author_facet | Zafra, Victoria García Torres, Alicia Hernández Vázquez, Elisa García Cogollos, Teresa Soria Jordana, Manuel Canteras Gómez, Joaquín Ruiz Gómez, Joaquín Gómez Martínez, Antonio Hernández Barberán, José |
author_sort | Zafra, Victoria García |
collection | PubMed |
description | PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) may complicate the treatment of diabetic foot infections (DFIs). The aim of this study was to determine the risk factors for these pathogens in DFIs. MATERIAL AND METHODS: This was a prospective observational study of 167 consecutive adult patients with DFIs. The diagnosis and severity of DFIs were based on the Infectious Disease Society of America (IDSA) classification system. Multivariate analyses were performed in order to identify risk factors for MRSA and ESBL-E infections. RESULTS: S. aureus was the most isolated pathogen (n= 82, 37.9 %) followed by Escherichia coli (n= 40, 18.5%). MRSA accounted for 57.3% of all S. aureus and 70% of Klebsiella pneumoniae and 25% of E. coli were ESBL producers, respectively. Deep ulcer [OR 8,563; 95% CI (1,068-4,727)], previous use of fluoroquinolones [OR 2,78; 95% CI (1,156-6,685)] and peripheral vasculopathy [OR 2,47; 95% CI (1.068-4.727)] were the independent predictors for MRSA infections; and osteomyelitis [OR 6,351; 95% CI (1,609-25,068)] and previous use of cephalosporins [OR 5,824; 95% CI (1,517-22,361)] for ESBL-E infections. CONCLUSIONS: MRSA and ESBL-E have adquired a great clinical relevance in DFIs. The availability of their risk factors is very convenient to choose the empirical treatment in severe forms. |
format | Online Article Text |
id | pubmed-7712337 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Sociedad Española de Quimioterapia |
record_format | MEDLINE/PubMed |
spelling | pubmed-77123372020-12-11 Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission Zafra, Victoria García Torres, Alicia Hernández Vázquez, Elisa García Cogollos, Teresa Soria Jordana, Manuel Canteras Gómez, Joaquín Ruiz Gómez, Joaquín Gómez Martínez, Antonio Hernández Barberán, José Rev Esp Quimioter Original PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) may complicate the treatment of diabetic foot infections (DFIs). The aim of this study was to determine the risk factors for these pathogens in DFIs. MATERIAL AND METHODS: This was a prospective observational study of 167 consecutive adult patients with DFIs. The diagnosis and severity of DFIs were based on the Infectious Disease Society of America (IDSA) classification system. Multivariate analyses were performed in order to identify risk factors for MRSA and ESBL-E infections. RESULTS: S. aureus was the most isolated pathogen (n= 82, 37.9 %) followed by Escherichia coli (n= 40, 18.5%). MRSA accounted for 57.3% of all S. aureus and 70% of Klebsiella pneumoniae and 25% of E. coli were ESBL producers, respectively. Deep ulcer [OR 8,563; 95% CI (1,068-4,727)], previous use of fluoroquinolones [OR 2,78; 95% CI (1,156-6,685)] and peripheral vasculopathy [OR 2,47; 95% CI (1.068-4.727)] were the independent predictors for MRSA infections; and osteomyelitis [OR 6,351; 95% CI (1,609-25,068)] and previous use of cephalosporins [OR 5,824; 95% CI (1,517-22,361)] for ESBL-E infections. CONCLUSIONS: MRSA and ESBL-E have adquired a great clinical relevance in DFIs. The availability of their risk factors is very convenient to choose the empirical treatment in severe forms. Sociedad Española de Quimioterapia 2020-11-27 2020 /pmc/articles/PMC7712337/ /pubmed/33246358 http://dx.doi.org/10.37201/req/101.2020 Text en © The Author 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/). |
spellingShingle | Original Zafra, Victoria García Torres, Alicia Hernández Vázquez, Elisa García Cogollos, Teresa Soria Jordana, Manuel Canteras Gómez, Joaquín Ruiz Gómez, Joaquín Gómez Martínez, Antonio Hernández Barberán, José Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission |
title | Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission |
title_full | Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission |
title_fullStr | Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission |
title_full_unstemmed | Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission |
title_short | Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase-producing Enterobacterales in patients with diabetic foot infections requiring hospital admission |
title_sort | risk factors for methicillin-resistant staphylococcus aureus and extended-spectrum ß-lactamase-producing enterobacterales in patients with diabetic foot infections requiring hospital admission |
topic | Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712337/ https://www.ncbi.nlm.nih.gov/pubmed/33246358 http://dx.doi.org/10.37201/req/101.2020 |
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