KHẢO SÁT ĐẶC ĐIỂM VI TRÙNG HỌC TRÊN BỆNH NHÂN ĐÁI THÁO ĐƯỜNG ĐƯỢC CHẨN ĐOÁN NHIỄM TRÙNG CHÂN NHẬP BỆNH VIỆN CHỢ RẪY

Abstract

Objective: To investigate the microbiological characteristics and antibiotic resistance patterns in diabetic patients hospitalized for foot infections at Cho Ray Hospital. Methods: A cross-sectional study was conducted on 65 diabetic foot infection patients from September to December 2024. Wound specimens were collected using the Levine technique, then cultured on MacConkey agar and sheep blood agar. Bacterial identification was performed using the VITEK-2 Compact or VITEK-MS (MALDI-TOF MS). Antimicrobial susceptibility testing was conducted with VITEK-2 Compact and interpreted according to CLSI 2023 guidelines. Results: A total of 65 positive cultures were obtained from 65 ulcerative lesions, yielding 80 bacterial isolates, including 52 monomicrobial (80%) and 13 polymicrobial (20%) infections. Among monomicrobial isolates, Gram-negative bacteria predominated (55.8%), with Escherichia coli being the most common (17.3%), followed by Acinetobacter baumannii, Klebsiella spp., and Proteus mirabilis (all 7.7%). Gram-positive bacteria accounted for 44.2%, with Staphylococcus aureus being the most frequent (34.6%). According to IWGDF/IDSA classification, S. aureus predominated in grade 2 infections and remained significant in grades 3–4, whereas Gram-negative bacteria, particularly E. coli and A. baumannii, were more frequently associated with severe infections. Regarding antibiotic susceptibility, S. aureus remained highly sensitive to vancomycin, teicoplanin, linezolid, TMP/SMX, and fusidic acid (≥80%) but showed high resistance to penicillins and quinolones. Gram-negative isolates demonstrated extensive multidrug resistance; however, carbapenems and tigecycline maintained the highest efficacy. Conclusion: Diabetic foot infections at Cho Ray Hospital were mainly caused by S. aureus and E. coli. The high prevalence of suspected MRSA and multidrug-resistant Gram-negative pathogens (particularly Klebsiella spp., Pseudomonas spp., and A. baumannii) poses major challenges for treatment.