糖尿病足创面多重耐药微生物感染的危险因素Meta分析  

Meta-analysis of Risk Factors for Multidrug-Resistant Organism Infection in Patients with Diabetic Foot Wounds

作　　者：毛森淼 张建萌 杨少玲 程琪 MAO Senmiao;ZHANG Jianmeng;YANG Shaoling;CHENG Qi(Department of Neurology,the Second Medical Centre,Chinese PLA General Hospital,Beijing 100089,China;Department of Patient Management,the 980th Hospital of the Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China;Department of Endocrinology,the 980th Hospital of the Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China;Endocrinology and Outpatient Department,the 980th Hospital of the Joint Logistic Support Force of the PLA,Shijiazhuang 050082,China)

机构地区：[1]解放军总医院第二医学中心神经内科,北京100089 [2]联勤保障部队第九八〇医院伤病员管理科,石家庄050082 [3]联勤保障部队第九八〇医院内分泌科,石家庄050082 [4]联勤保障部队第九八〇医院门诊部,石家庄050082

出　　处：《临床误诊误治》2025年第9期53-60,共8页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会指导性课题(20240696)。

摘　　要：目的 探讨糖尿病足创面多重耐药微生物(MDRO)感染的危险因素。方法 系统检索中国期刊全文数据库(CNKI)、万方数据资源系统(Wanfang)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、PubMed、Web of Science、EmBase、The Cochrane Library、Ovid及Proquest从建库截止到2024年9月3日所有关于糖尿病足创面MDRO危险因素的研究文献。依据制定的文献纳入和排除标准进行文献筛选和数据提取,提取纳入文献中的病例数、MDRO感染的危险因素等数据,合并分析糖尿病足创面MDRO感染的危险因素,使用卡斯尔-渥太华量表(NOS)评价研究文献的质量,选取中、高质量的文献,采用RevMan 5.3软件进行Meta分析。结果 最终纳入19篇文献,其中2篇为队列研究,17篇为病例对照研究,共计纳入8 638例,其中MDRO组1 583例,非MDRO组7 055例,文献质量为中、高等。Meta分析结果显示,骨髓炎[OR=3.23,95%CI(2.62,3.99)]、同一感染创面住院次数>2次/年[OR=2.60,95%CI(2.03,3.33)]、抗生素应用史[OR=2.01,95%CI(1.80,2.25)]、神经缺血性溃疡[OR=1.25,95%CI(1.16,1.34)]、创面病程[OR=1.34,95%CI(1.08,1.66)]和创面面积[OR=1.48,95%CI(1.03,2.14)]是糖尿病足创面MDRO感染的危险因素(P<0.05,P<0.01)。结论 骨髓炎、同一感染创面住院次数>2次/年、抗生素应用史、神经缺血性溃疡、创面面积和创面病程是糖尿病足创面MDRO感染的主要危险因素,在糖尿病足的临床诊治过程中如有上述危险因素,应及时处理以促进创面愈合。Objective To investigate the risk factors of multi-drug resistant organism(MDRO) infection in patients with diabetic foot wound.Methods A systematic search was conducted on Chinese Journal Full-Text Database CNKI,Wanfang Data Resource System(Wanfang),Chinese Biomedical Literature Database(CBM),VIP database,PubMed,Web of Science,EmBase,The Cochrane Library,Ovid and Proquest for all literature on MDRO risk factors for diabetic foot wounds from inception until September 3,2024.Literature screening and data extraction were carried out according to the established criteria for literature inclusion and exclusion.Data such as the number of cases in the included literature and the risk factors of MDRO infection were extracted,and the risk factors of MDRO infection in patients with diabetic foot wound were combined and analyzed.Newcastle-Ottawa Scale(NOS) was used to evaluate the quality of research literature,and medium and high quality literature were selected.Meta-analysis was performed using RevMan 5.3 software.Results Finally,19 literatures were included,including 2 cohort studies and 17 case-control studies.A total of 8 638 cases were included,including 1 583 cases in the MDRO group and 7 055 cases in the non-MDRO group.The literature quality was medium to high.The results of Meta-analysis showed that osteomyelitis [OR=3.23,95%CI(2.62,3.99)],times of hospitalization for the same infection wound >2 times/year [OR=2.60,95%CI(2.03,3.33)],antibiotic use history [OR=2.01,95%CI(1.80,2.25)],neuroischemic ulcer [OR=1.25,95%CI(1.16,1.34)],wound course [OR=1.34,95%CI(1.08,1.66)] and wound area [OR=1.48,95%CI(1.03,2.14)] were risk factors for MDRO infection in patients with diabetic foot wound(P<0.05,P<0.01).Conclusion Osteomyelitis,times of hospitalization for the same infection wound >2 times/year,history of antibiotic application,neuroischemic ulcer,wound area and wound course are the main risk factors for MDRO infection in patients with diabetic foot wound.If these risk factors are present in the clinical diagnosis and tre

关 键 词：糖尿病足 多重耐药微生物 危险因素 骨髓炎 抗生素应用史 神经缺血性溃疡 创面 META分析 

分 类 号：R587.29[医药卫生—内分泌]