{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T16:30:41Z","timestamp":1792859441846,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017959","name":"Health Commission of Hebei Province","doi-asserted-by":"publisher","award":["20240696"],"award-info":[{"award-number":["20240696"]}],"id":[{"id":"10.13039\/100017959","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Multidrug\u2010resistant (MDR) bacterial infections have become increasingly common in recent years due to the increased prevalence of diabetic foot ulcers (DFUs). We carried out a meta\u2010analysis aimed at investigating the prevalence of MDR bacteria isolated from DFUs and analysing the risk factors for MDR bacterial infection in patients with DFUs. The PubMed\/Medline, Web of Science, Embase, Cochrane Library, Ovid, Scopus, and ProQuest databases were searched for studies published up to November 2023 on the clinical outcomes of MDR bacteria in DFUs. The main outcome was the prevalence of MDR bacteria in DFUs. A total of 21 studies were included, representing 4885 patients from which 2633 MDR bacterial isolates were obtained. The prevalence of MDR bacteria in DFUs was 50.86% (95% confidence interval (CI): 41.92%\u201359.78%). The prevalence of MDR gram\u2010positive bacteria (GPB) in DFUs was 19.81% (95% CI: 14.35%\u201325.91%), and the prevalence of MDR gram\u2010negative bacteria (GNB) in DFUs was 32.84% (95% CI: 26.40%\u201339.62%). MDR\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (12.13% (95% CI: 8.79%\u201315.91%)) and MDR\n                    <jats:italic>Enterococcus<\/jats:italic>\n                    spp. (3.33% (95% CI: 1.92%\u20135.07%)) were the main MDR\u2010GPB in DFUs. MDR\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    , MDR\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    , MDR\n                    <jats:italic>Enterobacter<\/jats:italic>\n                    spp., MDR\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    , and MDR\n                    <jats:italic>Proteus mirabilis<\/jats:italic>\n                    were the main MDR\u2010GNB in DFUs. The prevalence rates were 6.93% (95% CI: 5.15%\u20138.95%), 6.01% (95% CI: 4.03%\u20138.33%), 3.59% (95% CI: 0.42%\u20139.30%), 3.50% (95% CI: 2.31%\u20134.91%), and 3.27% (95% CI: 1.74%\u20135.21%), respectively. The clinical variables of diabetic foot ulcer patients infected with MDR bacteria and non\u2010MDR bacteria in the included studies were analysed. The results showed that peripheral vascular disease, peripheral neuropathy, nephropathy, osteomyelitis, Wagner's grade, previous hospitalization and previous use of antibacterial drugs were significantly different between the MDR bacterial group and the non\u2010MDR bacterial group. We concluded that there is a high prevalence of MDR bacterial infections in DFUs. The prevalence of MDR\u2010GNB was greater than that of MDR\u2010GPB in DFUs. MDR\n                    <jats:italic>S.\u2009aureus<\/jats:italic>\n                    was the main MDR\u2010GPB in DFUs, and MDR\n                    <jats:italic>E.\u2009coli<\/jats:italic>\n                    was the main MDR\u2010GNB in DFUs. Our study also indicated that peripheral vascular disease, peripheral neuropathy, nephropathy, osteomyelitis, Wagner's grade, previous hospitalization, and previous use of antibacterial drugs were associated with MDR bacterial infections in patients with DFUs.\n                  <\/jats:p>","DOI":"10.1111\/iwj.14864","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T07:26:33Z","timestamp":1713165993000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Prevalence of multidrug\u2010resistant bacterial infections in diabetic foot ulcers: A meta\u2010analysis"],"prefix":"10.1111","volume":"21","author":[{"given":"Shaoling","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Endocrinology The Bethune International Peace Hospital  Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liye","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The Bethune International Peace Hospital  Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Gucheng County Hospital of Hebei Province  Gucheng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangzhe","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The Bethune International Peace Hospital  Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijia","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The Bethune International Peace Hospital  Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Hebei Medical University  Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.03.024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2016.1231932"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-017-0831-1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2018.0319"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5419874"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10091948"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.4102\/ajlm.v10i1.1261"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2019.10.009"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm-21-3406"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734614521236"},{"key":"e_1_2_9_15_1","first-page":"1464","article-title":"Isolation and genetic analysis of multidrug resistant bacteria from diabetic foot ulcers","volume":"6","author":"Shahi SK","year":"2015","journal-title":"Front Microbiol"},{"issue":"5","key":"e_1_2_9_16_1","first-page":"665","article-title":"Microbiological pattern of diabetic foot infections at a tertiary care centre in a developing country","volume":"67","author":"Miyan Z","year":"2017","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2018.02.013"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/9817308"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13473"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/jehp.jehp_1552_20"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S287852"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.18683\/germs.2021.1292"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.18683\/germs.2021.1239"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07382-7"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1721727X221127874"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-022-00957-0"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S359157"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.987487"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2022.11752"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.16162"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1113622"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/15347346211038090"},{"issue":"9","key":"e_1_2_9_33_1","first-page":"1931","article-title":"Infection characteristics and drug susceptibility of multidrug\u2010resistant bacteria in patients with diabetic foot ulcers","volume":"69","author":"Chen T","year":"2023","journal-title":"Clin Lab"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.46747-0"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1086\/591861"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0116"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2017.05.001"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2010.10.003"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-018-0645-6"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.11.001"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000658"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00406-y"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13465"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.881659"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40200-020-00639-5"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-020-01587-5"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/15347346211002715"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06516-7"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.18683\/germs.2020.1227"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.14864","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T06:32:57Z","timestamp":1754289177000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.14864"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/iwj.14864"],"URL":"https:\/\/doi.org\/10.1111\/iwj.14864","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-12-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14864"}}