Characteristics of multidrug-resistant bacterial infections in patients with calcaneal osteomyelitis and construction of a nomogram model
OBJECTIVE To analyze the characteristics of multidrug-resistant bacterial infections in patients with cal-caneal osteomyelitis,and to construct a risk column chart model to explore its predictive value.METHODS The clinical data of 198 patients with calcaneal osteomyelitis admitted to the First People's Hospital of Jiangxia District in Wuhan of Hubei Province(Xiehe Jiangnan Hospital)from Jan 2020 to Jan 2023 were retrospectively analyzed.They were divided into the infection group(32 cases)and the uninfected group(166 cases)according to whether multi-drug resistant bacteria infection occurred.The polymorphism distribution at the rs 45567233 locus of the ca-thepsin G(CTSG)gene and characteristics of multidrug-resistant bacterial infection between the infected and unin-fected groups were analyzed.Multivariate logistic regression analysis was used to analyze the risk factors of multi-drug-resistant bacterial infection in patients with calcaneal osteomyelitis,and a risk column chart model was con-structed to analyze its predictive value.RESULTS The frequency of AA genotype at rs 45567233 of GSTG gene in the infected group was lower than that in the uninfected group.The frequencies of GG genotype and G allele,and the levels of serum interleukin-6(IL-6)and C-reactive protein(CRP)were higher than those in the uninfected group(P＜0.05).Injury due to infection of diabetes foot complicated with infection,the number of operations,GG genotype at rs 45567233 site of GSTG gene were risk factors for multidrug-resistant bacterial infection in pa-tients with calcaneal osteomyelitis(P＜0.05).Prediction model was as follows:logit(P)=-3.327+injury due to infection of diabetes foot complicated with infection × 1.713+surgeries × 1.368+genotype GG × 1.835.The quasi curve results showed that the predicted probability was close to the actual probability,indicating that the regression model had good discrimination,calibration,and prediction capabilities.The receiver operating char-acteristic(ROC)curve showed that when logit(P)＞0.266,the area under the curve(AUC)value was 0.776,with a 95％CI of 0.681-0.871.The diagnostic sensitivity of the model was 63.12％,and the specificity was 90.60％,indicating good model discrimination.CONCLUSION Multidrug-resistant bacterial infections in patients with osteomyelitis of the heel were associated with GSTG gene polymorphisms,diabetic foot co-infections,and surgeries.And the risk column chart model constructed accordingly had good predictive value.
Calcaneal osteomyelitisMulti-drug resistant bacteria infectionCathepsin G gene polymorphismRisk factorColumn chart
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