Analysis of Risk Factors of Infection in Diabetic Foot Patients

Objectives: This cross-sectional study assessed the risk factors for infection in 150 diabetic foot patients admitted to the Xiamen University Hospital between October 2020 and October 2022. Methods: Patients were categorized as infected (n = 80) or uninfected (n = 70) cohorts. The diabetic foot was evaluated using the American Diabetic Foot Grading system, whereas ulcers were categorized using Wagner's method. Analyzed were patient-specific information, clinical data, and risk factors including neuropathy, arterial disease and foot deformities. Results: Our findings revealed no statistically significant differences between infected and uninfected cohorts concerning age, BMI, gender, duration of diabetes, or ankle-brachial index values (p > 0.05). However, infected group had a higher proportion of smokers and reduced socioeconomic status (p < 0.05). Wagner grades indicated a greater severity in the infected group, with grade 3, grade 4, and grade 5 differing significantly (p < 0.05). Comparative analysis of ulcer characteristics revealed no statistically significant differences in ulcer surface area and depth, but the infected group had a higher prevalence of osteomyelitis and a greater number of ulcers (p > 0.05). Blood vessel complications, retinopathy, the presence of three or more ulcers, osteomyelitis, and diabetic nephropathy were substantially more prevalent in the infected group, as determined by univariate analysis (p < 0.05). Subsequent multivariate logistic analysis revealed that patients with blood vessel complications, retinopathy, osteomyelitis, diabetic nephropathy, and three or more ulcers were at increased risk for infection (p < 0.05). In addition, lifestyle factors, such as smoking, sedentary behavior, inadequate foot hygiene, obesity, and poor glycemic control, were also associated with higher infection rates. A multivariate analysis of foot wound factors revealed that deeper, longer, and recurrent lesions increased the likelihood of infection. Escherichia coli was the most frequently isolated bacterium from the infected group's bacterial culture, followed by Pseudomonas aeruginosa and Staphylococcus aureus . Conclusion: The study enhanced our comprehension of the multifactorial risk factors associated with infections in diabetic foot patients, highlighting the need for thorough clinical evaluation, lifestyle modification, and vigilant infection control.