Study population characteristics.

The primary objective of this study was to isolate bacteria from diabetic foot ulcers and subsequently assess their antibiotic resistance capabilities. Seventy-five patients diagnosed with diabetic foot ulcers were investigated. A number of these patients (97.33%) had type 2 diabetes, with a significant proportion of them having been diagnosed for 1–5 years (29.33%). Notably, a substantial number of these individuals were on insulin usage (78.66%). Among the patients under examination, 49.33% reported having no use of tobacco products, alcohol, or betel leaf. The ulcers analyzed in this study were classified into grades 1–5 according to the Wagner scale. Wagner grade 2 diabetic foot ulcers had the highest number of culture-positive patients, at 33.33%. Pus samples collected from patients were cultured on selective media, and bacterial identity was confirmed by biochemical tests and polymerase chain reaction. A total of 141 isolates were isolated. Among the isolates, 82.97% gram-negative bacteria and 17.02% gram-positive bacteria were detected. Klebsiella pneumoniae was the most common isolate. Proteus spp., Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were also detected. Approximately 61.33% of the ulcers exhibited were polybacterial. In this study, it was observed that all bacterial isolates, except for Proteus spp., were primarily detected in patients classified under Wagner’s grade 2. Moreover, antibiotic susceptibility was also tested on these 141 isolates. Among them, Escherichia coli showed the highest multidrug resistance, 81.81%. Most of the gram-negative bacteria were resistant to ampicillin. All of the gram-negative isolates exhibited high levels of susceptibility to piperacillin-tazobactam, and these levels were Klebsiella pneumoniae (97.56%), Pseudomonas aeruginosa (95.24%), Escherichia coli (81.82%), and Proteus spp. (80%). On the other hand, gram-positive Staphylococcus aureus mostly showed sensitivity towards vancomycin and norfloxacin (79.17%).

本研究的核心目标为从糖尿病足溃疡（diabetic foot ulcers）病灶中分离病原菌，并后续评估其抗生素耐药性。本研究共纳入75例确诊糖尿病足溃疡的患者进行分析。其中97.33%的患者为2型糖尿病（type 2 diabetes），且有29.33%的患者病程为1~5年。值得注意的是，78.66%的患者接受胰岛素治疗。入组患者中，49.33%自述无烟草、酒精及槟榔摄入史。本研究中分析的溃疡按照瓦格纳（Wagner）分级标准分为1~5级，其中瓦格纳2级糖尿病足溃疡的培养阳性患者占比最高，达33.33%。从患者体内采集的脓液标本接种于选择性培养基进行培养，通过生化试验及聚合酶链式反应（polymerase chain reaction）确认病原菌种类，最终共分离得到141株病原菌。其中革兰氏阴性菌（gram-negative bacteria）占82.97%，革兰氏阳性菌（gram-positive bacteria）占17.02%。肺炎克雷伯菌（Klebsiella pneumoniae）为最常见的分离菌株，变形杆菌属（Proteus spp.）、大肠埃希菌（Escherichia coli）、铜绿假单胞菌（Pseudomonas aeruginosa）及金黄色葡萄球菌（Staphylococcus aureus）均有检出。约61.33%的溃疡标本为多菌混合感染。本研究观察到，除变形杆菌属外，其余所有分离病原菌均主要检出于瓦格纳分级2级的溃疡患者中。此外，本研究对这141株病原菌进行了药敏试验：其中大肠埃希菌的多重耐药率最高，达81.81%；多数革兰氏阴性菌对氨苄西林呈现耐药性。所有革兰氏阴性菌对哌拉西林-他唑巴坦均表现出较高的敏感性，具体为肺炎克雷伯菌97.56%、铜绿假单胞菌95.24%、大肠埃希菌81.82%、变形杆菌属80%。而革兰氏阳性菌中的金黄色葡萄球菌则大多对万古霉素及诺氟沙星敏感，敏感率为79.17%。