Abstract：
OBJECTIVE: To retrospectively analyze the concordance of bacterial culture between bone tissue and deep soft tissue in diabetic foot osteomyelitis (DFO) patients and clinical characteristics of patients.
METHODS: This study collected samples from 155 patients with suspected DFO (who required amputation after clinical evaluation). Bacterial culture and drug susceptibility tests were performed on the patients\' deep soft tissue and bone tissue, and the consistency between the two was compared. In addition, the differences among DFO patients with different degrees of infection were compared classified by the PEDIS classifications.
RESULTS: Among the 155 patients diagnosed with DFO, the positive rate of bone culture was 78.7% (122/155). This study cultured 162 strains, including 73 Gram-positive bacteria, 83 Gram-negative bacteria, and 6 fungi. Staphylococcus aureus (33 strains) was the most common bacteria. The overall agreement between bone culture and tissue culture was 42.8%, with Staphylococcus aureus and Enterobacteria having the best (64.3%) and least agreements (27.3%), respectively. The drug sensitivity results in bone culture showed that Staphylococcus aureus was the main Gram-positive bacteria. The bacteria were sensitive to linezolid and vancomycin. Proteus mirabilis was the main Gram-negative bacteria. These were more sensitive than biapenem and piperacillin/tazobactam. Fungi were more sensitive to voriconazole and itraconazole.
CONCLUSIONS: The culture results of deep soft tissues near the bone cannot accurately represent the true pathogen of DFO. For DFO patients, bone culture should be taken as much as possible, and appropriate antibiotics should be selected according to the drug susceptibility results.
METHODS: This study collected samples from 155 patients with suspected DFO (who required amputation after clinical evaluation). Bacterial culture and drug susceptibility tests were performed on the patients\' deep soft tissue and bone tissue, and the consistency between the two was compared. In addition, the differences among DFO patients with different degrees of infection were compared classified by the PEDIS classifications.
RESULTS: Among the 155 patients diagnosed with DFO, the positive rate of bone culture was 78.7% (122/155). This study cultured 162 strains, including 73 Gram-positive bacteria, 83 Gram-negative bacteria, and 6 fungi. Staphylococcus aureus (33 strains) was the most common bacteria. The overall agreement between bone culture and tissue culture was 42.8%, with Staphylococcus aureus and Enterobacteria having the best (64.3%) and least agreements (27.3%), respectively. The drug sensitivity results in bone culture showed that Staphylococcus aureus was the main Gram-positive bacteria. The bacteria were sensitive to linezolid and vancomycin. Proteus mirabilis was the main Gram-negative bacteria. These were more sensitive than biapenem and piperacillin/tazobactam. Fungi were more sensitive to voriconazole and itraconazole.
CONCLUSIONS: The culture results of deep soft tissues near the bone cannot accurately represent the true pathogen of DFO. For DFO patients, bone culture should be taken as much as possible, and appropriate antibiotics should be selected according to the drug susceptibility results.
摘要：
目的：回顾性分析糖尿病足骨髓炎(DFO)患者骨组织与深部软组织细菌培养的一致性及其临床特点。
方法：本研究收集了155例疑似DFO患者（临床评估后需要截肢）的样本。对患者的深部软组织和骨组织进行细菌培养和药敏试验,比较了两者的一致性。此外,采用PEDIS分类法对不同感染程度的DFO患者进行比较。
结果：在155例诊断为DFO的患者中，骨培养阳性率为78.7%(122/155)。本研究培养了162株菌株，包括73个革兰氏阳性菌,83革兰氏阴性菌，6种真菌。金黄色葡萄球菌(33株)是最常见的细菌。骨培养和组织培养的总体一致性为42.8%,金黄色葡萄球菌和肠杆菌的一致性最好(64.3%)，协议最少(27.3%)，分别。骨培养药敏结果显示,革兰阳性菌以金黄色葡萄球菌为主。细菌对利奈唑胺和万古霉素敏感。奇异变形杆菌是主要的革兰氏阴性菌。这些比比阿培南和哌拉西林/他唑巴坦更敏感。真菌对伏立康唑和伊曲康唑较敏感。
结论：骨附近深层软组织的培养结果不能准确代表DFO的真正病原体。对于DFO患者，应尽可能多地进行骨培养，应根据药敏结果选择合适的抗生素。
方法：本研究收集了155例疑似DFO患者（临床评估后需要截肢）的样本。对患者的深部软组织和骨组织进行细菌培养和药敏试验,比较了两者的一致性。此外,采用PEDIS分类法对不同感染程度的DFO患者进行比较。
结果：在155例诊断为DFO的患者中，骨培养阳性率为78.7%(122/155)。本研究培养了162株菌株，包括73个革兰氏阳性菌,83革兰氏阴性菌，6种真菌。金黄色葡萄球菌(33株)是最常见的细菌。骨培养和组织培养的总体一致性为42.8%,金黄色葡萄球菌和肠杆菌的一致性最好(64.3%)，协议最少(27.3%)，分别。骨培养药敏结果显示,革兰阳性菌以金黄色葡萄球菌为主。细菌对利奈唑胺和万古霉素敏感。奇异变形杆菌是主要的革兰氏阴性菌。这些比比阿培南和哌拉西林/他唑巴坦更敏感。真菌对伏立康唑和伊曲康唑较敏感。
结论：骨附近深层软组织的培养结果不能准确代表DFO的真正病原体。对于DFO患者，应尽可能多地进行骨培养，应根据药敏结果选择合适的抗生素。
