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당뇨발 환자에서 단일 절단 및 재수술 절단 사례의 병원체 검출 및 제거 비교 분석

Comparative Analysis of Pathogen Detection and Eradication in Single vs. Revision Amputation Cases of Diabetic Foot Patients

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Purpose: This study examined the differences in pathogen survival between single and revision amputations in diabetic foot infections. Current research lacks data on the postoperative pathogen profiles, particularly in cases involving repeated surgeries, making this study essential for targeted infection management. Materials and Methods: The medical records of 168 diabetic foot ulcer patients treated at a single center, divided into single (n=113) and revision amputation groups (n=55) were analyzed retrospectively. Preoperative deep tissue samples and postoperative wound swab samples were collected to analyze the pathogens. The C-reactive protein (CRP) levels were measured as an inflammation marker. The pathogen diversity, frequency, and survival rate were compared. The ‘survival rate’ was defined as the frequency of postoperative persistence of pathogens relative to the preoperative detection frequency. Results: Revision amputation cases showed a higher diversity (p=0.0029) and persistence of pathogens, with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa , and most other detected pathogens displaying higher survival rates. The CRP levels generally decreased postoperatively, but the variability was more pronounced in the revision group, suggesting that CRP may not consistently correlate with infection control in complex cases. Conclusion: These findings revealed significant differences in the pathogen profiles between single and revision amputations, with revision cases facing more significant infection challenges because of the higher resistant pathogen persistence.

Abstract

Purpose: This study examined the differences in pathogen survival between single and revision amputations in diabetic foot infections. Current research lacks data on the postoperative pathogen profiles, particularly in cases involving repeated surgeries, making this study essential for targeted infection management. Materials and Methods: The medical records of 168 diabetic foot ulcer patients treated at a single center, divided into single (n=113) and revision amputation groups (n=55) were analyzed retrospectively. Preoperative deep tissue samples and postoperative wound swab samples were collected to analyze the pathogens. The C-reactive protein (CRP) levels were measured as an inflammation marker. The pathogen diversity, frequency, and survival rate were compared. The ‘survival rate’ was defined as the frequency of postoperative persistence of pathogens relative to the preoperative detection frequency. Results: Revision amputation cases showed a higher diversity (p=0.0029) and persistence of pathogens, with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa , and most other detected pathogens displaying higher survival rates. The CRP levels generally decreased postoperatively, but the variability was more pronounced in the revision group, suggesting that CRP may not consistently correlate with infection control in complex cases. Conclusion: These findings revealed significant differences in the pathogen profiles between single and revision amputations, with revision cases facing more significant infection challenges because of the higher resistant pathogen persistence.

참고문헌 (24)

  1. Jeon JY, "1369-P: the natural trends in incidence of lower extremity amputations in South Korea, 2003-2021", Diabetes, 72(Suppl), pp.1369~ (2023)[DOI]
  2. Boulton AJ, "The global burden of diabetic foot disease", Lancet, 366, pp.1719~1724 (2005)
  3. Mendes JJ, "Clinical and bacteriological survey of diabetic foot infections in Lisbon", Diabetes Res Clin Pract, 95, pp.153~161 (2012)[DOI]
  4. Lipsky BA, "Topical versus systemic antimicrobial therapy for treating mildly infected diabetic foot ulcers : a randomized, controlled, double-blinded, multicenter trial of pexiganan cream", Clin Infect Dis, 47, pp.1537~1545 (2008)[DOI]
  5. Machado C, "Evolutionary trends in bacteria isolated from moderate and severe diabetic foot infections in a Portuguese tertiary center", Diabetes Metab Syndr, 14, pp.205~209 (2020)[DOI]
  6. Jneid J, "Exploring the microbiota of diabetic foot infections with culturomics", Front Cell Infect Microbiol, 8, pp.282~ (2018)[DOI]
  7. Dang CN, "Methicillin-resistant Staphylococcus aureus in the diabetic foot clinic : a worsening problem", Diabet Med, 20, pp.159~161 (2003)[DOI]
  8. Citron DM, "Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents", J Clin Microbiol, 45, pp.2819~2828 (2007)[DOI]
  9. Ramakant P, "Changing microbiological profile of pathogenic bacteria in diabetic foot infections : time for a rethink on which empirical therapy to choose?", Diabetologia, 54, pp.58~64 (2011)[DOI]
  10. Shanmugam P, "The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains", J Clin Diagn Res, 7, pp.441~445 (2013)[DOI]
  11. Uçkay I, "Diabetic foot infections : what have we learned in the last 30 years?", Int J Infect Dis, 40, pp.81~91 (2015)[DOI]
  12. Shankar EM, "Bacterial etiology of diabetic foot infections in South India", Eur J Intern Med, 16, pp.567~570 (2005)[DOI]
  13. Karmaker M, "Association of bacteria in diabetic and non-diabetic foot infection-an investigation in patients from Bangladesh", J Infect Public Health, 9, pp.267~277 (2016)[DOI]
  14. Al Benwan K, "A study of the microbiology of diabetic foot infections in a teaching hospital in Kuwait", J Infect Public Health, 5, pp.1~8 (2012)[DOI]
  15. Son ST, "The microbiology of diabetic foot infections in Korea", J Wound Manag Res, 13, pp.8~12 (2017)[DOI]
  16. Kwon KT, "Microbiology and antimicrobial therapy for diabetic foot infections", Infect Chemother, 50, pp.11~20 (2018)[DOI]
  17. Lee JS, "Risk factors of methicillin-resistant Staphylococcus aureus and Pseudomonas infection in diabetic foot ulcers in Korea", J Wound Manag Res, 17, pp.29~34 (2017)[DOI]
  18. Aragón-Sánchez J, "Revision surgery for diabetic foot infections : giving another chance to the patient", Int J Low Extrem Wounds, 12, pp.146~151 (2013)[DOI]
  19. Aziz Z, "Predictive factors for lower extremity amputations in diabetic foot infections", Diabet Foot Ankle, 2, pp.7463~ (2011)[DOI]
  20. Uysal S, "Risk factors for amputation in patients with diabetic foot infection : a prospective study", Int Wound J, 14, pp.1219~1224 (2017)[DOI]
  21. Lipsky BA, "2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections", Clin Infect Dis, 54, pp.e132~e173 (2012)[DOI]
  22. Lipsky BA, "IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes", Diabetes Metab Res Rev, 32(Suppl), pp.45~74 (2016)[DOI]
  23. Huang Y, "A comparison of tissue versus swab culturing of infected diabetic foot wounds", Int J Endocrinol, 2016, pp.8198714~ (2016)[DOI]
  24. Bravo-Molina A, "Influence of wound scores and microbiology on the outcome of the diabetic foot syndrome", J Diabetes Complications, 30, pp.329~334 (2016)[DOI]

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