Risk factors for infection with multidrug-resistant organisms in diabetic foot ulcer patients: A systematic review and meta-analysis

Objective: To systematically evaluate the risk factors for multidrug-resistant organisms (MDROs) infection in patients with diabetic foot ulcer(DFU). Methods: The quality assessment of outcome measures was performed by searching the Web of Science, Embase library, PubMed, Cochrane Library databases and screening the literature on the risk factors of MDROs infection in DFU patients according to the inclusion and exclusion criteria, and meta-analysis was performed using revman5.3 analysis software. Results: 13 literature was retrieved, involving in 1715 patients. A total of 15 risk factors were included in the analysis and the meta-analysis showed that Previous hospitalization(OR=2.61,95％CI[1.51,4.52],P=0 .0006), Previous antibiotic use(OR=2.17,95％CI[1.24-3.78],P<0.01), Type of diabetes(OR=2.44,95％CI[1.29-4.63],P<0.01), Nature of ulcer(OR=2.16,95％CI[1.06-4.40],P=0.03), Size of ulcer(OR=2.56,95％CI[1.53-4.28],P<0.01), Osteomyelitis(OR=3.50,95％CI[2.37-5.17],P<0.01), Peripheral vascular disease(OR=2.37,95％CI[1.41-3.99],P<0.01),and Surgical treatment(OR=4.81,95％CI[2.95-7.84],P<0.01)were closely associated with MDROs infection in DFU patients. Conclusions: The risk factors of MDROs infection in patients with DFU were previous hospitalization, previous antibiotic use, type of diabetes, nature of ulcer, size of ulcer, osteomyelitis, peripheral vascular disease, and surgical treatment. This study is conducive to early detection of MDROs infection in high-risk groups and timely comprehensive treatment to delay the development of the disease.