The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection
dc.authorid | Sahin Ozdemir, Meryem/0000-0002-3928-3840 | |
dc.authorid | altay, fatma aybala/0000-0002-7149-2968 | |
dc.authorid | Sürme, Serkan/0000-0001-7239-1133 | |
dc.authorid | acar, ali/0000-0001-6478-2206 | |
dc.authorid | Kurt, Ahmet Furkan/0000-0002-7454-7557 | |
dc.authorid | Acar, Ali/0000-0003-2008-5112 | |
dc.authorscopusid | 6602089825 | |
dc.authorscopusid | 57200418093 | |
dc.authorscopusid | 57216659259 | |
dc.authorscopusid | 6506689252 | |
dc.authorscopusid | 57223049137 | |
dc.authorscopusid | 57217217031 | |
dc.authorscopusid | 6602738477 | |
dc.authorwosid | Sahin Ozdemir, Meryem/ABB-1122-2021 | |
dc.authorwosid | KINIKLI, Sami/IYJ-9555-2023 | |
dc.authorwosid | altay, fatma aybala/AFP-3599-2022 | |
dc.authorwosid | Tulek, Necla/M-3283-2017 | |
dc.authorwosid | Sürme, Serkan/AAA-4823-2021 | |
dc.authorwosid | Saltoǧlu, Neşe/AAV-2262-2021 | |
dc.authorwosid | Kurt, Ahmet Furkan/AAM-5129-2021 | |
dc.contributor.author | Saltoglu, Nese | |
dc.contributor.author | Surme, Serkan | |
dc.contributor.author | Ezirmik, Elif | |
dc.contributor.author | Kadanali, Ayten | |
dc.contributor.author | Kurt, Ahmet Furkan | |
dc.contributor.author | Sahin Ozdemir, Meryem | |
dc.contributor.author | Kinikli, Sami | |
dc.date.accessioned | 2024-07-05T15:21:25Z | |
dc.date.available | 2024-07-05T15:21:25Z | |
dc.date.issued | 2023 | |
dc.department | Atılım University | en_US |
dc.department-temp | [Saltoglu, Nese; Surme, Serkan; Kurt, Ahmet Furkan; Sahin Ozdemir, Meryem] Istanbul Univ Cerrahpasa, Istanbul, Turkey; [Ezirmik, Elif] Istanbul Univ, Istanbul, Turkey; [Kadanali, Ayten] Biruni Univ, Sch Med, Istanbul, Turkey; [Kadanali, Ayten; Cakar, Zeynep Sule] Univ Hlth Sci, Umraniye Educ & Res Hosp, Istanbul, Turkey; [Ak, Oznur] Dumlupinar Univ, Kutahya, Turkey; [Ak, Oznur] Univ Hlth Sci, Kartal Educ & Res Hosp, Istanbul, Turkey; [Altay, Fatma Aybala; Acar, Ali] Univ Hlth Sci, Diskapi Yildirim Beyazit Educ & Res Hosp, Ankara, Turkey; [Acar, Ali; Tulek, Necla] Atilim Univ, Ankara, Turkey; [Tulek, Necla; Kinikli, Sami] Univ Hlth Sci, Ankara Educ & Res Hosp, Ankara, Turkey | en_US |
dc.description | Sahin Ozdemir, Meryem/0000-0002-3928-3840; altay, fatma aybala/0000-0002-7149-2968; Sürme, Serkan/0000-0001-7239-1133; acar, ali/0000-0001-6478-2206; Kurt, Ahmet Furkan/0000-0002-7454-7557; Acar, Ali/0000-0003-2008-5112 | en_US |
dc.description.abstract | We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 +/- 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection (p = .043) and vancomycin treatment (p = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency (p = .004), hospital readmission (p = .009), C-reactive protein > 130 mg/dL (p = .007), and receiving carbapenems (p = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials. | en_US |
dc.identifier.citation | 8 | |
dc.identifier.doi | 10.1177/15347346211004141 | |
dc.identifier.endpage | 290 | en_US |
dc.identifier.issn | 1534-7346 | |
dc.identifier.issn | 1552-6941 | |
dc.identifier.issue | 2 | en_US |
dc.identifier.pmid | 33856261 | |
dc.identifier.scopus | 2-s2.0-85104645892 | |
dc.identifier.scopusquality | Q1 | |
dc.identifier.startpage | 283 | en_US |
dc.identifier.uri | https://doi.org/10.1177/15347346211004141 | |
dc.identifier.uri | https://hdl.handle.net/20.500.14411/2083 | |
dc.identifier.volume | 22 | en_US |
dc.identifier.wos | WOS:000643450400001 | |
dc.identifier.wosquality | Q3 | |
dc.language.iso | en | en_US |
dc.publisher | Sage Publications inc | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
dc.rights | info:eu-repo/semantics/closedAccess | en_US |
dc.subject | diabetic foot infection | en_US |
dc.subject | antimicrobial resistance | en_US |
dc.subject | multidrug-resistant organisms | en_US |
dc.subject | reinfection | en_US |
dc.subject | major amputation | en_US |
dc.title | The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection | en_US |
dc.type | Article | en_US |
dspace.entity.type | Publication |