title: Changes in Bacterial Profiles and Antibiotic Sensitivity Before and After Wound Bed Preparation for Diabetic Foot Ulcers.
abstract: We aimed to investigate the characteristics of bacterial profiles and antibiotic sensitivity in diabetic foot ulcers before and after wound bed preparation. This study involved 423 diabetic patients with Wagner grades 1 to 4 foot ulcers. Secretion culture was performed before wound bed preparation. The observation endpoint was when the wound showed a tendency toward healing and a specialist determined that stopping antibiotic treatment would not affect wound healing. A second secretion culture was performed after the observation endpoint. We obtained results from both secretion cultures from 411 patients. The proportion of multi-drug-resistant (MDR) gram-positive bacteria was 22.0% and 47.8% before and after treatment, respectively; that for gram-negative bacteria was 3.5% and 19.2%, respectively (P < .05). Pretreatment antibiotic sensitivity of staphylococci and other gram-positive bacteria was 48.7% and 44.8%, respectively; the rates decreased significantly after treatment to 36.8% (P = .031) and 34.8% (P = .027), respectively. Pretreatment antibiotic sensitivity of common and nonfermenting rare gram-negative bacteria was 55.4% and 54.6%, respectively, which decreased substantially after treatment to 33.2% (P = .002) and 32.9% (P = .003), respectively. Wound healing was achieved in 92.7% of patients. Pretreatment and posttreatment C-reactive protein levels were 124.759 ± 71.58 mg/dL and 82.8 ± 53.61 mg/dL, respectively (P < .05). In conclusion, following wound bed preparation for diabetic foot ulcers, MDR bacteria numbers were increased and antibiotic sensitivity was decreased; inflammation was decreased. These findings warrant future studies for confirmation.
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Wang
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Jinghua
authors.initials: J
authors.lastname: Tian
authors.affiliation: Bethune International Peace Hospital of Chinese PLA, Shijiazhuang, China.
authors.forename: Lv-Yun
authors.initials: LY
authors.lastname: Zhu
authors.affiliation: Bethune International Peace Hospital of Chinese PLA, Shijiazhuang, China.
authors.forename: Shaoling
authors.initials: S
authors.lastname: Yang
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Yudong
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Fusheng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Capital University of Medical Science, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Capital University of Medical Science, Beijing, China xxying7341@126.com.
authors.forename: Xuying
authors.initials: X
authors.lastname: Xu
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification*; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D014945:Wound Healing / Q000187:drug effects*; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; bacteria; diabetes; diabetic foot ulcer; pathogens