Correlation analysis of diabetic foot ulcer patients with different Wagner grades with clinical characteristics as well as distribution of pathogenic bacteria

LI Xueyan; LI Juan; HE Yafei; WU Pengfei; WANG Wei; GUO Yiyi; GAO Hongran; GAO Xiang

doi:10.3969/j.issn.1002-3429.2025.21.012

Abstract：Objective To investigate the correlation between patients with diabetic foot ulcers(DFU)of different Wagner grades and clinical characteristics,as well as the distribution characteristics of pathogenic bacteria.Methods A total of 300 hospitalized DFU patients admitted between January 2022 and June 2024 were selected and divided into two groups based on Wagner grades:≤Grade 3(n=186)and>Grade 3(n=114).Clinical data,laboratory indicators,and pathogen culture results were collected to analyze correlation between different Wagner grades and clinical indicators as well as differences in pathogen distribution among DFU patients.Results he>Grade 3 group had a higher age,along with significantly elevated white blood cell(WBC),neutrophil(NEUT),platelet count(PLT),fasting C peptide,C reactive protein(CRP),serum amyloid A(SAA),and fibrinogen(FIB)levels,and significantly reduced hemoglobin(Hb)and albumin(ALB)levels,as compared with≤Grade 3 group(P<0.05).Correlation analysis showed that age,WBC,NEUT,PLT,CRP,SAA,and FIB were significantly positively correlated with Wagner grade(r=0.248,0.281,0.255,0.229,0.246,0.177,0.247,P<0.05),and that Hb and ALB levels were significantly negatively correlated with Wagner grade(r=-0.256,P<0.001;r=-0.190,P=0.001).A total of 522 pathogenic strains were isolated and cultured,of which Gram-positive bacteria accounted for 22.61%(118/522),predominantly Staphylococcus aureus(81 strains,15.52%),with susceptibility rates of 100%to vancomycin,linezolid,tigecycline,and quinupristin.Gram-negative bacteria accounted for 77.39%(404/522),primarily Pseudomonas aeruginosa(143 strains,27.39%)and Acinetobacter baumannii(60 strains,11.49%).Among these,Pseudomonas aeruginosa showed high susceptibility to amikacin,cefepime,and imipenem.As compared with≤Grade 3 group,the>Grade 3 group had a higher proportion of Gram-negative bacteria(82.20%vs.74.62%,P=0.046).Conclusion As the Wagner grade increases,the detection rate of Gram-negative bacilli in DFU patients rises,along with elevated levels of inflammatory and coagulation factors.This suggests that attention should be paid to differences in clinically isolated strains in DFU patients with different Wagner grades.