Impact of the COVID-19 Pandemic on Diabetic Foot Patients: A Shift in the Infectious Agent Profile Toward Nonfermentative Gram-Negative Bacilli.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-05-01 DOI:10.7547/22-073
Ali Acar, Neşe Saltoğlu, Necla Tülek, Özge Turhan, Elif Nazlı Serin, Derya Yapar, Murat Kendirci, Serkan Sürme, Banu Yıldız Karaca, Fatma Aybala Altay, Rıdvan Tayşi, İrfan Şencan, Esra Tanyel, Heval Can Bilek, Özlem Güler, Birsen Mutlu, Tolga Aksan, Fatma Yılmaz Karadağ, Ayten Kadanalı, Lütfiye Nilsun Altunal, Moumperra Chral Oglu, Seniha Şenbayrak, Serpil Erol, Öznur Ak, Nazire Aladağ, Neşe Demirtürk, Petek Konya, Dilek Bulut, Derya Öztürk Engin, Hasan Murat Aslan, Sibel Doğan Kaya
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引用次数: 0

Abstract

Background: Diabetes foot infection is a very important public health problem that causes serious health problems, mortality, and high health expenditures, and is one of the most important complications of diabetes mellitus. There are concerns that approaches such as limited personal visits to doctors, avoidance of hospitals, and restrictions on nonemergency surgical procedures during the coronavirus disease of 2019 pandemic pose a threat to those with diabetic foot problems, including diabetic foot ulcers (DFUs), ischemia, and infection, resulting in increased limb loss and mortality.

Methods: This multicenter, retrospective, cross-sectional study was conducted in 14 tertiary care hospitals from various regions of Turkey. A total of 1,394 patient records were evaluated, 794 of which were between January 1, 2019, and January 30, 2020 (prepandemic [Pre-P]), and 605 of which were between February 1, 2020, and February 28, 2021 (pandemic period [PP]).

Results: During the PP, diabetic foot patient follow-up decreased by 23.8%. In addition, the number of hospitalizations attributable to DFU has decreased significantly during the PP (P = .035). There was no difference between the groups regarding patient demographics, medical history, DFU severity, biochemical and radiologic findings, or comorbidities, but the mean duration of diabetes mellitus years was longer in patients in the Pre-P than in those in the PP (15.1 years versus 13.7 years). There was no difference between the two groups in terms of major complications such as limb loss and mortality, but infection recurrence was higher in the PP than in the Pre-P (12.9% versus 11.4%; P < .05). The prevalence of nonfermentative gram-negative bacteria as causative agents in DFU infections increased during the PP. In particular, the prevalence of carbapenem-resistant Pseudomonas spp. increased statistically during the PP.

Conclusions: The rapid adaptation to the pandemic with the measures and changes developed by the multidisciplinary diabetic foot care committees may be the reasons why there was no increase in complications because of DFU during the pandemic in Turkey.

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COVID-19 大流行对糖尿病足患者的影响:感染病原体向非发酵革兰氏阴性杆菌转变。
背景:糖尿病足感染是一个非常重要的公共卫生问题,会导致严重的健康问题、死亡率和高昂的医疗支出,是糖尿病最重要的并发症之一。有人担心,在 2019 年冠状病毒病大流行期间,限制个人看病、避免去医院、限制非急诊外科手术等做法会对糖尿病足患者构成威胁,包括糖尿病足溃疡(DFU)、缺血和感染,从而导致肢体缺失和死亡率增加:这项多中心、回顾性、横断面研究在土耳其不同地区的 14 家三级医院进行。共评估了 1,394 份患者病历,其中 794 份病历的时间跨度为 2019 年 1 月 1 日至 2020 年 1 月 30 日(大流行前 [Pre-P]),605 份病历的时间跨度为 2020 年 2 月 1 日至 2021 年 2 月 28 日(大流行期 [PP]):结果:在大流行期间,糖尿病足患者的随访率下降了 23.8%。此外,在大流行期间,因 DFU 而住院的人数也明显减少(P = .035)。两组患者在人口统计学、病史、DFU 严重程度、生化和放射学检查结果或合并症方面没有差异,但预治疗组患者的平均糖尿病病程比治疗组更长(15.1 年对 13.7 年)。两组患者在肢体缺失和死亡率等主要并发症方面没有差异,但PP组的感染复发率高于Pre-P组(12.9%对11.4%;P < .05)。非发酵性革兰阴性菌作为DFU感染致病菌的流行率在PP期间有所上升。特别是,在 PP 期间,耐碳青霉烯类假单胞菌的流行率出现了统计学上的增长:土耳其多学科糖尿病足护理委员会制定的措施和改变迅速适应了大流行,这可能是土耳其大流行期间DFU并发症没有增加的原因。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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