Saibal M A A, Rahman S H Z, Nishat L, Sikder N H, Begum S A, Islam M J, Uddin K N
Department of Medicine, Eastern Medical College Hospital, Comilla.
Bangladesh Med Res Counc Bull. 2012 Dec;38(3):98-103. doi: 10.3329/bmrcb.v38i3.14336.
Both community acquired pneumonia (CAP) and diabetes mellitus are common in Bangladesh. Though hospitalization of diabetic patients with CAP is increasing, data regarding their clinical presentation, microbial characteristics, antimicrobial susceptibility and outcome are lacking. This study was aimed at finding any difference in clinical presentation, bacterial causes, antimicrobial susceptibility pattern of isolated bacteria and outcome in diabetic and non-diabetic hospitalized patients with CAP. In this study total 47 diabetic and 43 non-diabetic adult hospitalized patients with CAP were enrolled. Clinical presentation of CAP differed in diabetics and non-diabetics. Frequency of atypical presentation and CURB-65 score were significantly higher in diabetics. Pleural effusion with multilobar infiltration was also common feature for CAP in diabetic patients. Klebsiella pneumoniae was the most frequent causative pathogen for CAP in diabetic patients, whereas Streptococcus pneumoniae was the most frequent causative agent for non-diabetic patients. Bacteria isolated from sputum sample of diabetic patients with CAP were resistant to almost all recommended antibiotics used for CAP but 100% of isolates were sensitive to Carbapenems. Pulmonary complications were relatively more in diabetics than in non-diabetics. Hospitalized diabetics with CAP required referral to intensive care unit more than that of non-diabetics. So, diabetic patients with CAP need extra attention.
社区获得性肺炎（CAP）和糖尿病在孟加拉国均很常见。尽管糖尿病合并CAP患者的住院率在上升，但关于其临床表现、微生物特征、抗菌药物敏感性及预后的数据却很缺乏。本研究旨在找出糖尿病和非糖尿病住院CAP患者在临床表现、细菌病因、分离细菌的抗菌药物敏感性模式及预后方面的差异。本研究共纳入了47例糖尿病和43例非糖尿病成年住院CAP患者。糖尿病和非糖尿病患者的CAP临床表现有所不同。糖尿病患者非典型表现的频率和CURB-65评分显著更高。多叶浸润伴胸腔积液也是糖尿病患者CAP的常见特征。肺炎克雷伯菌是糖尿病患者CAP最常见的致病病原体，而肺炎链球菌是非糖尿病患者最常见的病原体。从糖尿病CAP患者痰液样本中分离出的细菌对几乎所有推荐用于CAP的抗生素耐药，但100%的分离株对碳青霉烯类敏感。糖尿病患者的肺部并发症相对多于非糖尿病患者。糖尿病住院CAP患者比非糖尿病患者更需要转入重症监护病房。因此，糖尿病CAP患者需要格外关注。
