{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T20:13:53Z","timestamp":1787948033827,"version":"build-2784847793"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T00:00:00Z","timestamp":1588809600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multidrug-resistant organisms (MDROs) are important diabetic foot infection (DFI) pathogens. This study evaluated the impact of DFIs associated with MDRO pathogens (DFI-MDRO) on clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adults admitted to Detroit Medical Center from January 2012 to December 2015 with culture-positive DFI were included. Associations between outcomes and DFI-MDRO (evaluated as a single group that included methicillin-resistant Staphylococcus aureus [MRSA], vancomycin-resistant enterococci, Enterobacteriaceae resistant to third-generation cephalosporin [3GCR-EC], Acinetobacter baumannii, and Pseudomonas aeruginosa) were analyzed. Outcomes included above- and below-knee lower extremity amputation (LEA), readmissions, and mortality within a year after DFI. A propensity score predicting the likelihood of having DFI-MDRO was computed by comparing patients with DFI-MDRO with patients with DFI with non-MDRO pathogens (DFI-non-MDRO). Using conditional logistic regression, DFI-MDRO was analyzed as an independent variable after patients in the MDRO and non-MDRO groups were matched by propensity score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six hundred forty-eight patients were included, with a mean age \u00b1 SD of 58.4 \u00b1 13.7. Most patients in the cohort presented with chronic infection (75%). DFI-MDRO occurred in greater than one-half of the cohort (n = 364, 56%), and MRSA was the most common MDRO (n = 224, 62% of the DFI-MDRO group). In propensity-matched analyses, DFI-MDRO was not associated with 1-year LEA or readmissions, but was associated with recurrent DFI episodes (odds ratio, 2.1; 95% confidence interval, 1.38\u20133.21).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DFI-MDRO was associated with a 2-fold increased risk of recurrent DFI compared with patients with DFI-non-MDRO.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ofid\/ofaa161","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T06:32:49Z","timestamp":1588833169000},"source":"Crossref","is-referenced-by-count":39,"title":["The Impact of Multidrug-Resistant Organisms on Outcomes in Patients With Diabetic Foot Infections"],"prefix":"10.1093","volume":"7","author":[{"given":"Oryan","family":"Henig","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA"},{"name":"Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M","family":"Pogue","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services, Sinai-Grace Hospital, Detroit Medical Center, Detroit, Michigan, USA"},{"name":"School of Medicine, Wayne State University, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umar","family":"Hayat","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Detroit Medical Center, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Ja\u2019ara","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Detroit Medical Center, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul E","family":"Kilgore","sequence":"first","affiliation":[{"name":"Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Cha","sequence":"first","affiliation":[{"name":"Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorab","family":"Dhar","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith S","family":"Kaye","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"key":"2020053002200031600_CIT0001","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.dsx.2018.10.014","article-title":"Potential risk factors and outcomes of infection with multidrug resistance among diabetic patients having ulcers: 7 years study","volume":"13","author":"Zubair","year":"2019","journal-title":"Diabetes Metab Syndr"},{"key":"2020053002200031600_CIT0002","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.2337\/dc05-2425","article-title":"Risk factors for foot infections in individuals with diabetes","volume":"29","author":"Lavery","year":"2006","journal-title":"Diabetes Care"},{"key":"2020053002200031600_CIT0003","doi-asserted-by":"crossref","DOI":"10.3402\/dfa.v4i0.21847","article-title":"The system of care for the diabetic foot: objectives, outcomes, and 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