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糖尿病足中多药耐药性细菌感染的流行病学,风险因素和预测模型的外部验证

Xiangheng Dai¹, Fuzhou Xu², Weiqi Lu²

¹Department of Spinal Surgery, Shaoguan First People's Hospital, Guangdong Medical University, Shaoguan, People's Republic of China.

Infection and drug resistance

|September 4, 2025

概括

糖尿病足中的多药耐药性细菌感染与特定的患者因素有关. 现有预测模型的准确性较差,强调需要改进的工具来管理这些感染.

科学领域:

传染性疾病
内分泌学
公共卫生

背景情况:

糖尿病足易受感染,通常是由多药耐药细菌 (MDRB) 引起的.
准确预测MDRB,Pseudomonas aeruginosa (PSA) 和耐甲金 Staphylococcus (MRSA) 是有效治疗的关键.

研究的目的:

在DFU患者中调查MDRB,PSA和MRSA的流行病学特征和危险因素.
对这些感染进行外部验证现有的预测模型.

主要方法:

在344名DFU患者的回顾性分析.
用于确定风险因素的单变量和多变量逻辑回归.
用于模型验证的接收器操作特性 (ROC) 曲线和校准分析.

主要成果:

与更长时间住院,低血红蛋白,高hs-CRP和骨质疏松症相关的MDRB感染.
显著的MDRB风险因素:长时间住院,骨髓炎,骨质疏松症,先前使用的抗菌药物和呼吸率.
与心肌梗塞和周围血管疾病相关的PSA感染;没有发现MRSA的显著风险因素.
外部验证显示所有细菌类型的模型性能不佳 (AUC < 0. 6).

结论:

特定的临床因素与DFU中的MDRB有关.
现有的预测模型缺乏通用性,需要对DFU群体进行改进.
未来的研究应专注于增强DFU感染的预测模型和有针对性的抗菌策略.

关键词:

糖尿病足部模型验证多种耐药性细菌预测模型危险因素

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