Characteristics of Multidrug-Resistant Bacteria Infection and Analysis of Risk Factors in Diabetic Foot Complicated with Osteomyelitis

[ABSTRACT] Objective To investigate the pathogen distribution, antimicrobial resistance trends, and associated risk factors in patients with diabetic foot osteomyelitis (DFO). Methods A retrospective analysis was conducted on the clinical data of 102 patients diagnosed with DFO admitted to Bethune International Peace Hospital from January 2004 to December 2024. The study analyzed pathogen distribution, antimicrobial susceptibility patterns, and risk factors for multidrug-resistant organism (MDRO) infection in DFO patients. Results 1. Of the 102 patients, 71.5% had MDRO infection, while 28.5% had non-MDRO infection. 2. Multivariate analysis identified diabetes duration, wound duration, anemia, and lower extremity ischemia as independent risk factors for MDRO infection in DFO (P=0.038, 0.026, 0.035, 0.036). 3. A nomogram prediction model for MDRO infection risk was established based on the four independent risk factors, with an area under the ROC curve (AUC) of 0.906 Conclusions In patients with MDRO-infected DFO, G+ bacteria were predominantly Staphylococcus aureus and Enterococcus faecalis . G- bacteria were mainly Proteus mirabilis , Escherichia coli , Klebsiella pneumoniae , and Enterobacter cloacae . Diabetes duration, wound duration, anemia, and lower limb ischemia are independent predictors of MDRO infection. The established nomogram provides an effective tool for evaluating the risk of MDRO infection in DFO patients.