Correlating Climate Conditions With Pseudomonas aeruginosa Prevalence in Diabetic Foot Infections Within the United States.

IF 3.8 4区 医学 Q2 IMMUNOLOGY
Open Forum Infectious Diseases Pub Date : 2024-10-19 eCollection Date: 2024-11-01 DOI:10.1093/ofid/ofae621
Rebecca Winski, Jiachen Xu, Jonathan Townsend, Arthur Chan, Bethany A Wattengel, Matthew Davis, Andrew Puckett, Kyle Huntsman, Ashley L O'Leary, Kari A Mergenhagen
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引用次数: 0

Abstract

Background: The 2023 "International Working Group on the Diabetic Foot/Infectious Disease Society of America Guidelines on the Diagnosis and Treatment of Diabetes-Related Foot Infections" (DFIs) provides recommendations for Pseudomonas coverage based on the climate region.

Methods: This was a retrospective national study of veterans between 1/1/2010 and 3/23/2024 with diabetes mellitus and a culture below the malleolus wound. Prevalence of Pseudomonas was categorized based on climate zones according to the International Energy Conservation Code. Multivariable logistic regression was used to determine odds ratios and 97.5% CIs.

Results: The prevalence of Pseudomonas significantly varied between US climates. Pseudomonas was most prevalent within the Hot Humid climate, where it was isolated in 11.6% of DFI cultures. Pseudomonas was least prevalent within the Very Cold climate, where it was isolated in 6.2% of cultures. In the multivariable logistic regression model, hot and humid climates were associated with an odds of P. aeruginosa of 1.92 (97.5% CI, 1.69-2.20), a hot, dry climate was associated with an odds of 1.65 (97.5% CI, 1.44-1.90), and a humid climate was associated with an odds of 1.65 (97.5% CI, 1.45-1.89). A lower Charlson Comorbidity Index, inpatient admission, recent antipseudomonal antibiotic use, and swabs were less likely to have Pseudomonas. Recent admission increased the odds of P. aeruginosa (odds ratio [OR], 1.34; 97.5% CI, 1.27-1.41). History of P. aeruginosa was associated with an increase in P. aeruginosa (OR, 8.90; 97.5% CI, 8.29-9.56).

Conclusions: The prevalence of DFI organisms varies within different US climates. Utilization of local climate information may allow for more accurate and targeted empiric antibiotic selection when treating DFIs.

美国境内气候条件与糖尿病足感染中铜绿假单胞菌流行率的相关性。
背景:2023 年《糖尿病足国际工作组/美国传染病学会糖尿病足相关感染诊断和治疗指南》(DFIs)根据气候区域提供了假单胞菌覆盖范围的建议:这是一项全国性的回顾性研究,研究对象是 2010 年 1 月 1 日至 2024 年 3 月 23 日期间患有糖尿病并在踝骨下方伤口进行过培养的退伍军人。假单胞菌的流行率是根据《国际节能规范》按气候区域划分的。采用多变量逻辑回归确定几率比和 97.5% CIs:结果:假单胞菌的流行率在美国不同气候区之间存在显著差异。假单胞菌在湿热气候中最普遍,11.6% 的 DFI 培养物中都分离到了假单胞菌。在极冷气候中假单胞菌的流行率最低,只有 6.2% 的培养物中分离出假单胞菌。在多变量逻辑回归模型中,湿热气候与铜绿假单胞菌的几率为 1.92(97.5% CI,1.69-2.20),干热气候与 1.65(97.5% CI,1.44-1.90)的几率有关,潮湿气候与 1.65(97.5% CI,1.45-1.89)的几率有关。夏尔森综合指数(Charlson Comorbidity Index)较低、住院、近期使用抗假单胞菌抗生素和拭子的患者感染假单胞菌的几率较低。近期入院会增加铜绿假单胞菌感染的几率(几率比 [OR],1.34;97.5% CI,1.27-1.41)。铜绿假单胞菌病史与铜绿假单胞菌的增加有关(OR,8.90;97.5% CI,8.29-9.56):美国不同气候条件下 DFI 微生物的流行率各不相同。利用当地气候信息可在治疗 DFI 时更准确、更有针对性地选择经验性抗生素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Open Forum Infectious Diseases
Open Forum Infectious Diseases Medicine-Neurology (clinical)
CiteScore
6.70
自引率
4.80%
发文量
630
审稿时长
9 weeks
期刊介绍: Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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