title: Clinical outcomes of multidrug resistant pseudomonas aeruginosa infection and the relationship with type III secretion system in patients with diabetic foot.
abstract: The objective was to analyze the clinical outcomes of multidrug resistant Pseudomonas aeruginosa (MDRPA) infection and determine the relationship between type III secretion system (TTSS) and MDRPA in diabetic foot (DF) patients. A total of 117 patients infected with P aeruginosa were recruited and grouped into MDRPA and non-MDRPA group according to antimicrobial susceptibility testing. TTSS genes were detected by polymerase chain reaction (PCR). Potential risk factors for MDRPA infection were examined using univariate and multivariate analyses. Clinical outcomes were compared on the basis of MDRPA or TTSS virulence gene. Previous antibiotic therapy, previous hospitalization and osteomyelitis were associated with MDRPA infection. MDRPA group had a higher amputation/toe rate (32.6% vs 16.2%) and lower healing rate (20.9% vs 41.9%) than non-MDRPA group (P = .032). A significantly higher proportion of exoU was present in MDRPA group (75.0% vs 25.0%, P < .05) than non-MDRPA group. Patients infected with exoU isolates had a lower healing rate and higher amputation/toe rate (25.0% vs 65.2%, 33.3% vs 8.7%, P < .05) than infected with exoS isolates. The exoU gene was predominance among MDRPA strains. The poor clinical outcomes of MDRPA infection in patients with DF were attributable to exoU gene.
authors.affiliation: 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development(Ministry of Health), Department of Diabetic foot, the Metabolic Disease Hospital,Tianjin Institute of Endocrinology,Tianjin Medical University, Tianjin, China.
authors.forename: Jinghang
authors.initials: J
authors.lastname: Zhang
authors.affiliation: 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development(Ministry of Health), Department of Diabetic foot, the Metabolic Disease Hospital,Tianjin Institute of Endocrinology,Tianjin Medical University, Tianjin, China.
authors.forename: Yuejie
authors.initials: Y
authors.lastname: Chu
authors.affiliation: 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development(Ministry of Health), Department of Diabetic foot, the Metabolic Disease Hospital,Tianjin Institute of Endocrinology,Tianjin Medical University, Tianjin, China wph200000@163.com.
authors.forename: Penghua
authors.initials: P
authors.lastname: Wang
authors.affiliation: 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development(Ministry of Health), Department of Diabetic foot, the Metabolic Disease Hospital,Tianjin Institute of Endocrinology,Tianjin Medical University, Tianjin, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Ji
authors.affiliation: 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development(Ministry of Health), Department of Diabetic foot, the Metabolic Disease Hospital,Tianjin Institute of Endocrinology,Tianjin Medical University, Tianjin, China.
authors.forename: Xiwen
authors.initials: X
authors.lastname: Li
authors.affiliation: 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development(Ministry of Health), Department of Diabetic foot, the Metabolic Disease Hospital,Tianjin Institute of Endocrinology,Tianjin Medical University, Tianjin, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.affiliation: 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development(Ministry of Health), Department of Diabetic foot, the Metabolic Disease Hospital,Tianjin Institute of Endocrinology,Tianjin Medical University, Tianjin, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Peng
mesh_terms: D000368:Aged; D058947:Bacterial Secretion Systems; D017719:Diabetic Foot / Q000150:complications*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000502:physiology*
chemical_list: D058947:Bacterial Secretion Systems
keywords: Pseudomonas aeruginosa; diabetic foot infection; multidrug resistant; type III secretion system