Antibiotic resistance in diabetic foot infection: how it changed with COVID-19 pandemic in a tertiary care center. (May 2021)

• Record Type: Journal Article
• Authors: Caruso, Paola; Maiorino, Maria Ida; Macera, Margherita; Signoriello, Giuseppe; Castellano, Laura; Scappaticcio, Lorenzo; Longo, Miriam; Gicchino, Maurizio; Campitiello, Ferdinando; Bellastella, Giuseppe; Coppola, Nicola; Esposito, Katherine
• Is Part Of: Diabetes research and clinical practice. Volume 175(2021)
• Publication Date: 2021-05
• Subjects: Type 2 diabetes -- Diabetic foot infection -- Antibiotic resistance -- Amputation -- Diabetic foot ulcer; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2021.108797
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aim: To investigate the rate of antibiotic resistance and its main risk factors in a population of patients with diabetic foot infection (DFI) during the COVID-19 pandemic, in comparison with the population of 2019. Methods: Two hundred and twenty-five patients with DFI were admitted in a tertiary care center from January 2019 to December 2020. Antibiotic resistance was evaluated by microbiological examination of soft tissues' or bone's biopsy. Results: Compared with 2019 group (n = 105), 2020 group (n = 120) had a significantly higher prevalence of antibiotic resistance [2019 vs 2020, 36% vs 63%, P <0.001] and more often was admitted with recent or current antibiotic therapy (18% vs 52%, P <0.001), which was frequently self-administered (5% vs 30%, P = 0.032). The risk of antibiotic resistance was also higher in 2020 group [OR 95% CI, 2.90 (1.68 to 4.99)]. Prior hospitalization, antibiotic self-administration and antibiotic prescription by general practitioners resulted as independent predictors of antibiotic resistance. Conclusions: In a population of people with DFI admitted in a tertiary care center during the COVID-19 pandemic the prevalence of antibiotic resistance was higher than 2019. Previous hospitalization, antibiotic self-administration /prescription by general practitioners were related to higher risk of antibiotic resistant infections.