ArticleJournal of public health research2026
High prevalence of multidrug-resistant bacteria in diabetic patients with foot ulcers: A descriptive analysis of patients referred to a tertiary care hospital in Vietnam.
Article in Journal of public health research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Misuse of antibiotics in diabetic foot infections (DFI) promotes multidrug-resistant (MDR) bacteria. Objectives: To describe antibiotic resistance patterns in patients with prior antibiotic exposure before tertiary hospital admission. Methods: A descriptive cross-sectional study followed STROBE guidelines from November 2022 to May 2023. Inclusion criteria were DFI patients with ≥ 48-hour prior antibiotic exposure at lower-level facilities. Clinical characteristics, infection severity, and bacterial cultures were assessed. Results: Among 51 patients (64.7% male, mean age 61.1 years), results showed elevated inflammatory markers (WBC: 15.1 k/uL; CRP: 109.2 mg/L) and poor glycemic control (HbA1c: 10.2%). Ulcers were large (mean: 10.1 cm^2) with 85.3% moderate-to-severe infections. Out of 51 samples, 38 (74.5%) yielded positive isolates. Among these isolates, the MDR prevalence was 84.2% (32/38). MDR infection was significantly associated with moderate-to-severe ulcers (OR: 10.8; 95% CI: 1.48-78.8; p=0.007). Conclusion: A high prevalence of MDR bacteria was identified among referred DFI patients, indicating a significant resistance burden in this population. These findings suggest a potential link between prior antibiotic exposure and increased resistance risk, underscoring the need for robust antimicrobial stewardship within referral networks.
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