Vaishnav Bhumika, Wadivkar Aniruddh, Pailla Ruchitha, Mondkar Saish
General Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, IND.
Cureus. 2024 Aug 1;16(8):e65955. doi: 10.7759/cureus.65955. eCollection 2024 Aug.
Background and aim Type 2 diabetes mellitus (T2DM) is associated with several infections due to hyperglycemia and impaired immunity. This study aims to analyze the clinical and microbiological profile of critically ill T2DM patients with sepsis due to gram-negative bacteria (GNB). Materials and methods A prospective cross-sectional observational study was conducted at Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, India, between December 2023 and May 2024, after ethics committee approval. A total of 100 patients (50 T2DM cases and 50 nondiabetic controls), diagnosed with sepsis due to GNB and admitted to the medical ICU, were included in the study. The clinical profile and laboratory investigations of these patients were studied. Cultures were obtained from peripheral/central venous samples, tracheal secretions, and urine samples. Cultures from other specimens, such as ascitic fluid, cerebrospinal fluid, and pus from skin and soft tissue infections, were also obtained. The statistical tests that were applied were two-tailed with a 95% CI, and a p-value of less than 0.05 was considered statistically significant. Results The mean age of critically ill T2DM cases was 60.52 ± 12.88 years. Of the 50 T2DM cases, 28 were males and 22 were females. The most common infection in critically ill T2DM patients was bloodstream infection (n = 21), followed by bronchopneumonia (n = 16) and urinary tract infections (n = 10). (n = 15) and (n = 15) were the most common gram-negative pathogens isolated. The most common GNB isolated from the blood cultures of critically ill T2DM patients was spp. (n = 6). The death rate was significantly higher in T2DM patients with GNB sepsis as compared to nondiabetic controls. Conclusion GNBs like , , and spp. are commonly found in critically ill T2DM patients with sepsis. Bloodstream infection was the most common site of infection in critically ill T2DM cases. spp. was the most common isolate found in the blood cultures of critically ill T2DM patients. It is important to identify the site of sepsis, isolate the organism, and treat it with appropriate antibiotics promptly in critically ill T2DM patients to improve the outcomes of these patients.
背景与目的 2型糖尿病（T2DM）与多种感染相关，原因在于高血糖和免疫功能受损。本研究旨在分析因革兰氏阴性菌（GNB）导致脓毒症的重症T2DM患者的临床和微生物学特征。材料与方法 2023年12月至2024年5月期间，在印度浦那的D.Y.帕蒂尔医学院、医院及研究中心进行了一项前瞻性横断面观察研究，该研究已获得伦理委员会批准。共有100名患者（50例T2DM患者和50例非糖尿病对照）纳入研究，这些患者因GNB导致脓毒症并入住内科重症监护病房。对这些患者的临床特征和实验室检查进行了研究。从外周/中心静脉样本、气管分泌物和尿液样本中获取培养物。还从其他标本中获取培养物，如腹水、脑脊液以及皮肤和软组织感染的脓液。所应用的统计检验为双侧检验，95%置信区间，p值小于0.05被认为具有统计学意义。结果 重症T2DM患者的平均年龄为60.52±12.88岁。在50例T2DM患者中，男性28例，女性22例。重症T2DM患者中最常见的感染是血流感染（n = 21），其次是支气管肺炎（n = 16）和尿路感染（n = 10）。 （n = 15）和 （n = 15）是分离出的最常见革兰氏阴性病原体。从重症T2DM患者血培养中分离出的最常见GNB是 菌属（n = 6）。与非糖尿病对照相比，GNB脓毒症的T2DM患者死亡率显著更高。结论 、 和 菌属等GNB在因脓毒症的重症T2DM患者中普遍存在。血流感染是重症T2DM病例中最常见的感染部位。 菌属是重症T2DM患者血培养中最常见的分离菌株。对于重症T2DM患者，识别脓毒症部位、分离病原体并及时使用适当抗生素进行治疗，对于改善这些患者的预后非常重要。
