OBJECTIVE To explore the distribution and drug resistance of pathogens isolated from the diabetes mellitus patients complicated with skin soft tissue infections (SSTI) so as to provide guidance for reasonable clinical use of antibiotics.

METHODS A total of 1177 diabetes mellitus patients with SSTI who were hospitalized in endocrinology department of Zhongda Hospital Affiliated to Southeast University from Jan. 2016 to Dec. 2023 were recruited as the research subjects. The wound secretion specimens were cultured for pathogens, and the drug susceptibility testing was performed. The pathogens isolated in the 8 years and the results of drug susceptibility testing for the main pathogens were divided into the first 4-year group (from 2016 to 2019) and the last 4-year group (from 2020 to 2023).

RESULTS Among the 1177 patients with SSTI, the patients with diabetic foot infections accounted for 76.10%. Among the 1383 strains of isolated pathogens, there were 815 (58.93%) strains of gram-positive bacteria, 529 (38.25%) strains of gram-negative bacteria, and 39 (2.82%) strains of fungi. The constituent ratio of Staphylococcus aureus strains of the last 4-year group was lower than that of the first 4-year group, while the constituent ratio of Pseudomonas aeruginosa strains of the last 4-year group was higher than that of the first 4-year group (P < 0.05). The drug resistance rate of the S. aureus strains to oxacillin and the drug resistance rate of Streptococcus agalactiae strains to erythromycin were increased, and the drug resistance rate of Escherichia coli strains to ampicillin-sulbactam was increased (P < 0.05). The P. aeruginosa strains that were resistant to piperacillin-tazobactam, ceftazidime, cefepime, tobramycin, gentamycin, amikacin, ciprofloxacin and levofloxacin were detected in the last 4-year group. Among 7 strains of Candida glabrata, 1 strain was resistant to fluconazole, and 2 strains were resistant to itraconazole.

CONCLUSIONS There are a great variety of pathogens isolated from the diabetes mellitus patients complicated with SSTI, the gram-positive bacteria are dominant. The drug resistance rates of the major species of pathogens are remarkably higher in the last 4-year group than in the first 4-year group.