Pattern of infections in patients with diabetes mellitus—Data from a tertiary care medical centre in Indian sub-continent

Abstract

Summary We analysed the pattern of, and predispositions to, infections in patients with diabetes mellitus admitted in Endocrinology division of a tertiary care hospital. Methods The hospital records of 380 consecutive diabetic patients admitted with infection were screened for age, sex, type and duration of diabetes, glycemic control, clinical and laboratory evidence of microvascular complications of diabetes, coronary artery disease and the site/type of infection and available relevant microbiologic studies. An equal number of sex matched diabetic patients admitted without infections served as controls. Results Diabetic patients with infections were older (50.5 years versus 46.6 years), had diabetes of longer duration (6.6 years versus 5.5 years), and had higher fasting glucose (282 mg/dl versus 210 mg/dl), triglycerides (192 mg/dl versus 174 mg/dl) and creatinine (1.1 mg/dl versus 0.9 mg/dl). The prevalence of microvascular complications and coronary artery disease were significantly higher in the group with infections. The infections encountered included soft tissue infections (171, 42.8%), pulmonary infections (121, 30.2%), urinary tract infections (108, 28.4%) and more than one infection (20, 5.3%); two patients had rhinocerebral mucormycosis. Overall Staphylococcus aureus was the most frequently isolated pathogen, causing 62.93% of soft tissue infections and 20% of bacterial pulmonary infections. About one-fifth of the patients with infection had pulmonary tuberculosis. Conclusion Longer duration of diabetes, presence of diabetes specific complications and older age are risk factors for development of infection in patients with diabetes. Soft tissue infections and pulmonary tuberculosis are particular causes for concern in our diabetic population.