Microbial Etiology of Bacteremia in Controlled and Uncontrolled Type-2 Diabetes in Eastern Part of India

Abstract

Bacteremia in Type 2 Diabetes (T2D) is the most serious public health issue. Very limited information is available in this aspect with reference to complications. We hypothesized that abnormal increase in blood sugar levels may result in different bacterial infection associated with different categories of complications. Therefore, the aim of the present study was to evaluate and investigate the possible causes of bacteremia in T2D patients and its related complications in eastern region of the country where the data is unavailable to the best of our knowledge. The study included a total of 244 established T2D patients and 20 healthy controls in and around Bhubaneswar region, Odisha. Staging of T2D was done as per standard criteria into controlled and uncontrolled T2D. Blood samples were collected from all subjects including healthy controls and culture was done for bacterial isolation, identification. Prevalence of bacteremia was more among the uncontrolled cases (70.1%) than the controlled ones (29.8%) compared to healthy controls with p<0.0001. Occurrence of both gram positive and gram negative bacteria were found which comprised of Staphylococcus sp., Streptococcus, Bacilli, E. coli, Klebsiella. These groups of bacteria were thought as the causes of T2D complications. Eastern region of India being called as sweet region have a great affinity towards food and entertainment. So, we expect a higher intensity of sugar level in their blood and culture which often remains undiagnosed and develop to complications. Therefore, in our results we evaluated a strong connection of hyperglycemia with bacteremia providing a key for good empiric treatment in such high risk population.