Jonas Salm, Franziska Ikker, Elias Noory, Ulrich Beschorner, Tobias Siegfried Kramer, Siegbert Rieg, Dirk Westermann, Thomas Zeller
{"title":"2012 年至 2021 年的单中心队列显示,缺血性足部感染后续病例中的抗菌药耐药性并未增加。","authors":"Jonas Salm, Franziska Ikker, Elias Noory, Ulrich Beschorner, Tobias Siegfried Kramer, Siegbert Rieg, Dirk Westermann, Thomas Zeller","doi":"10.1111/iwj.14961","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <p>Patients with chronic limb-threatening ischaemia (CLTI) are at risk of foot infections, which is associated with an increase in amputation rates. The use of antibiotics may lead to a higher incidence of antimicrobial resistance (AMR) in subsequent episodes of ischaemic foot infections (IFI). This retrospective single-centre cohort study included 130 patients with IFI undergoing endovascular revascularisation. <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i> were the two most common pathogens, accounting for 20.5% and 10.8% of cases, respectively. The prevalence of antimicrobial resistance (AMR) and multi-drug resistance did not significantly increase between episodes (10.2% vs. 13.4%, <i>p</i> = 0.42). In 59% of subsequent episodes, the identified pathogens were unrelated to the previous episode. However, the partial concordance of identified pathogens significantly increased to 66.7% when <i>S. aureus</i> was identified (<i>p</i> = 0.027). Subsequent episodes of IFI in the same patient are likely to differ in causative pathogens. However, in the case of <i>S. aureus</i>, the risk of reinfection, particularly with <i>S. aureus</i>, is increased. Multi-drug resistance does not appear to change between IFI episodes. Therefore, recommendations for empirical antimicrobial therapy should be based on local pathogen and resistance statistics without the need to broaden the spectrum of antibiotics in subsequent episodes.</p>\n </section>\n </div>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.14961","citationCount":"0","resultStr":"{\"title\":\"Antimicrobial resistance is not increasing in subsequent cases of ischaemic foot infections, a single-centre cohort from 2012 to 2021\",\"authors\":\"Jonas Salm, Franziska Ikker, Elias Noory, Ulrich Beschorner, Tobias Siegfried Kramer, Siegbert Rieg, Dirk Westermann, Thomas Zeller\",\"doi\":\"10.1111/iwj.14961\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <p>Patients with chronic limb-threatening ischaemia (CLTI) are at risk of foot infections, which is associated with an increase in amputation rates. The use of antibiotics may lead to a higher incidence of antimicrobial resistance (AMR) in subsequent episodes of ischaemic foot infections (IFI). This retrospective single-centre cohort study included 130 patients with IFI undergoing endovascular revascularisation. <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i> were the two most common pathogens, accounting for 20.5% and 10.8% of cases, respectively. The prevalence of antimicrobial resistance (AMR) and multi-drug resistance did not significantly increase between episodes (10.2% vs. 13.4%, <i>p</i> = 0.42). In 59% of subsequent episodes, the identified pathogens were unrelated to the previous episode. However, the partial concordance of identified pathogens significantly increased to 66.7% when <i>S. aureus</i> was identified (<i>p</i> = 0.027). Subsequent episodes of IFI in the same patient are likely to differ in causative pathogens. However, in the case of <i>S. aureus</i>, the risk of reinfection, particularly with <i>S. aureus</i>, is increased. Multi-drug resistance does not appear to change between IFI episodes. 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Antimicrobial resistance is not increasing in subsequent cases of ischaemic foot infections, a single-centre cohort from 2012 to 2021
Patients with chronic limb-threatening ischaemia (CLTI) are at risk of foot infections, which is associated with an increase in amputation rates. The use of antibiotics may lead to a higher incidence of antimicrobial resistance (AMR) in subsequent episodes of ischaemic foot infections (IFI). This retrospective single-centre cohort study included 130 patients with IFI undergoing endovascular revascularisation. Staphylococcus aureus and Pseudomonas aeruginosa were the two most common pathogens, accounting for 20.5% and 10.8% of cases, respectively. The prevalence of antimicrobial resistance (AMR) and multi-drug resistance did not significantly increase between episodes (10.2% vs. 13.4%, p = 0.42). In 59% of subsequent episodes, the identified pathogens were unrelated to the previous episode. However, the partial concordance of identified pathogens significantly increased to 66.7% when S. aureus was identified (p = 0.027). Subsequent episodes of IFI in the same patient are likely to differ in causative pathogens. However, in the case of S. aureus, the risk of reinfection, particularly with S. aureus, is increased. Multi-drug resistance does not appear to change between IFI episodes. Therefore, recommendations for empirical antimicrobial therapy should be based on local pathogen and resistance statistics without the need to broaden the spectrum of antibiotics in subsequent episodes.
期刊介绍:
The Editors welcome papers on all aspects of prevention and treatment of wounds and associated conditions in the fields of surgery, dermatology, oncology, nursing, radiotherapy, physical therapy, occupational therapy and podiatry. The Journal accepts papers in the following categories:
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