Infections In Diabetic Patients Research Articles

Therapeutic Repurposing of Antidiabetic Drugs in Diabetes-associated Comorbidities

Background: Diabetic patients suffer from various comorbidities like cardiovascular diseases (CVDs), cancer, obesity, cognitive impairment, gout, leishmaniasis, etc. Objective: We aimed to review the pathological links between diabetes and its comorbidities and discuss the justification for using antidiabetic drugs in diabetes and associated comorbidities. Methods: Diabetic patients accompanied by comorbidities had to undergo a multidrug regimen apart from their common antidiabetic drugs, which affects their quality of life. There have been reports that some antidiabetic drugs ameliorate the comorbidities associated with diabetes. For instance, metformin is implicated in CVDs, cancer, as well as in cognitive impairment like Alzheimer's disease (AD); glyburide, a sulfonylurea, is found to be effective against leishmaniasis; and voglibose, an α- glucosidase inhibitor, is found to have suitable binding property against SARS-CoV-2 infection in diabetic patients. Targeting the comorbidities of diabetes with antidiabetic drugs may reduce the load of multidrug therapy in diabetic patients. Results: The effectiveness of antidiabetic drugs against some diabetic comorbidities between the two pathophysiological conditions, i.e., diabetes and its comorbidities, may be due to certain bidirectional links like inflammation, oxidative stress, disruption in the metabolic milieu and obesity. There are published reports of the repurposing of antidiabetic drugs for specific diseases, however, compiled repurposed reports of antidiabetic drugs for a wide range of diseases are scarce. Conclusion: In this review, we attempt to justify the use of antidiabetic drugs in diabetes and associated comorbidities.

Prevalence and Associated Factors of Urinary Tract Infections among Diabetes Mellitus Patients at KIU-TH from January to December 2022

Globally, an estimated 150 million individuals are affected by urinary tract infections (UTIs) every year, with a significant number of those affected being diabetics. The International Diabetes Federation (IDF) reported that in the year 2019, there were about 60 million cases of patients suffering from diabetes who developed UTIs. The study assessed the prevalence and associated factors of urinary tract infections among diabetic mellitus patients in the medical ward at KIUTH. The objectives were to find out the prevalence and the factors associated with urinary tract infections among diabetic patients in the medical ward of KIU-TH. The study was descriptive, and it involved 87 patient files selected by purposive sampling, in which a checklist was the main tool of data collection. The study showed that female gender was significantly associated with the occurrence of urinary tract infection in diabetic patients at OR 0.17 (0.05–4.29) and PV 0.01. The study also shows that having other disease comorbidities was significantly associated with the occurrence of UTI among diabetic patients at OR 0.58 (0.35-8.07) and PV 0.002. The study also shows that having late diabetic disease among diabetic patients was also significantly associated with the occurrence of UTI among diabetic patients at OR 0.69 (0.35-8.19) and PV 0.004. The study concluded that 48 (55.2%) of diabetic patients had had a urinary tract infection, and therefore the study recommends that diabetic patients should be health educated on the causes and control of UTI so as to prevent their occurrences. The study also recommends that the government increase service provisions like treatments to reduce the occurrence of opportunistic conditions in UTIs, and the patients should be encouraged to seek regular medical checkups so that they monitor disease progression. Keywords: Diabetics, UTIs, Patients, Diabetes mellitus.

Diabetes and Risk of Surgical Site Infection: A Narrative Review

Background: Diabetes Mellitus (DM) significantly elevates the risk of surgical site infections (SSIs), a major postoperative complication that increases morbidity, prolongs hospital stay, and escalates healthcare costs. The complex interplay between hyperglycemia-induced immunosuppression, impaired wound healing, and the increased propensity for infections in diabetic patients underscores the need for a comprehensive understanding of the mechanisms at play and effective management strategies. Objective: This narrative review aims to synthesize current evidence on the relationship between DM and the risk of SSIs, emphasizing the pathophysiological mechanisms, the impact of glycemic control on surgical outcomes, and the role of advanced surgical techniques in mitigating this risk. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for studies published up to April 2023, using keywords related to DM, SSIs, and perioperative management. Inclusion criteria targeted studies on the association between DM and SSIs, focusing on outcomes in diabetic versus non-diabetic patients, and the effectiveness of glycemic control. Data extraction and synthesis were performed using a narrative approach, with quality assessment based on study design-specific appraisal tools. Results: The review highlights that diabetic patients exhibit a significantly higher risk of developing SSIs compared to non-diabetic individuals, attributed to impaired immune response, microvascular complications, and delayed wound healing associated with hyperglycemia. Effective preoperative and postoperative glycemic control, maintaining hemoglobin A1c (HbA1c) levels below 7%, has been shown to reduce the incidence of SSIs. Furthermore, advancements in minimally invasive surgical techniques have contributed to lower SSI rates by reducing tissue trauma and preserving immune function. Conclusion: Diabetes mellitus is a significant risk factor for surgical site infections, underscoring the importance of stringent glycemic control and the adoption of advanced surgical techniques in the perioperative management of diabetic patients. Future research should focus on refining glycemic control strategies, understanding the genetic and molecular mechanisms underlying increased SSI risk, and developing targeted therapies to improve surgical outcomes in this high-risk population.

Association of Demographic Characteristics and Laboratory Values in Diabetic Foot Infections Leading to Lower-Extremity Amputation.

Lower-extremity amputations are a common complication of poorly controlled diabetes and contribute to significant morbidity and mortality in diabetic patients. We sought to determine whether objective data points obtained on presentation or hospital admission, including white blood cell (WBC) count, hemoglobin A1c (HbA1c), C-reactive protein (CRP), and descriptive patient demographics allow for the ability to predict optimal amputation levels and outcomes of lower-extremity amputation in the diabetic population. A retrospective analysis of 162 patients was performed evaluating laboratory and descriptive values on hospital presentation for lower-extremity infection during a 16-year period. Occurrence of multiple amputations and level of amputation were assessed against laboratory values to determine whether these objective values would provide clinicians with a better understanding of amputations in the diabetic patient. The mean patient age was 60.6 years. A significantly higher percentage of patients who underwent amputations through the tibia and fibula or of the foot midtarsal were male compared with patients who underwent amputations of the thigh through femur. Patients who had amputations through the tibia and fibula had a significantly higher WBC count compared with patients who had a transmetatarsal amputation (P = .03). There was no significant difference in type or quantity of amputations when analyzing HbA1c and CRP levels. An admission WBC count may be used as a predictor of lower-extremity amputation level and outcomes in diabetic infections. Although a statistically significant difference was not found for CRP or HbA1c levels between amputation procedures and number of procedures performed, these values remain useful in managing lower-extremity infections in diabetic patients.

Carbapenemase-Producing Klebsiella pneumoniae Infections in Diabetic and Nondiabetic Hospitalized Patients.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has recently attracted widespread attention due to its limited treatment options and significant morbidity and mortality rates. This study aimed to examine the relationship between risk factors and antimicrobial resistance in individuals with and without diabetes for the development of carbapenemase-producing K. pneumoniae infections. Between May 2019 and January 2021, a prospective study involving patients with and without diabetes who were infected with K. pneumonia, was carried out in a tertiary care hospital. Six hundred K. pneumoniae isolates were collected from various clinical samples, such as pus/wound samples, urine, respiratory samples, blood, and body fluids. An antimicrobial susceptibility test in K. pneumoniae was performed and compared between diabetics and nondiabetics. Univariate and multivariate logistic regression were used to identify independent risk factors for K. pneumoniae infections in the diabetic group and nondiabetic group separately. Multiplex PCR was used to detect genes that produce carbapenemase. A total of 600 patients were infected with K. pneumoniae, with 300 (50%) being diabetic and 300 (50%) being nondiabetic. We found that diabetics had higher antimicrobial resistance to numerous routinely used drugs for infection than the nondiabetic group. In the multivariate analysis of the variables, it was found that immunosuppressive therapy, prior antibiotic use, mechanical ventilation, and urinary catheter use were all significant risk factors influencing the development of K. pneumoniae infections in diabetic patients. Diabetics had a higher prevalence of carbapenemase-producing K. pneumoniae than nondiabetics. Outcome measures in K. pneumoniae patients revealed that the diabetic group had considerably higher infection-related mortality. We found that CRKP infection was associated with higher resistance to antibiotics in the diabetic group. Furthermore, the diabetic group had a higher prevalence of carbapenemase-producing K. pneumoniae than the nondiabetic group. Crucially, in order to lower mortality without worsening antibiotic resistance and metabolic damage, more focus has to be placed on sensible and efficient antibiotic and supportive care therapies.

Dalbavancin real-life utilization among diabetic patients suffering from infections in Italy and Spain: The DALBADIA retrospective cohort study

ObjectivesTo retrospectively describe the patterns of use of dalbavancin for treating infections in diabetic patients in Italian and Spanish standard clinical practice. MethodsDALBADIA [NCT04959799] was a multicentre, observational, retrospective cohort study, conducted in Italy and Spain. The study enrolled 97 adults with type 1 or 2 diabetes mellitus, treated with dalbavancin as per standard clinical practice for a Gram-positive bacterial infection or the Gram-positive component of a mixed infection. ResultsDalbavancin was used to treat cellulitis (18/92 patients, 19.6%), followed by prosthetic joint infection (14 patients, 15.2%), endocarditis (13 patients, 14.1%), and primary bacteraemia (10 patients, 10.9%); 78/92 (84.8%) patients had Gram-positive infections only, and 14 (15.2%) had mixed infections. The most frequently isolated microorganisms were Staphylococcus aureus in 43 (55.8% of the patients with microbial isolation), 25.6% of which methicillin-resistant; Staphylococcus epidermidis in 13 (16.9%), 53.8% of which methicillin-resistant; Enterococcus faecalis in 11 (14.3%). The main reason for the dalbavancin choice was the intent to simplify the antibiotic regimen (81.5% of cases). A multidisciplinary team participated in the treatment choice process for 53 (57.6%) patients. Dalbavancin was given as first-line antibiotic in 34 (37.0%) patients and administered as one infusion in 32 (34.8%), and as two infusions in 39 (42.4%). In total, 57/62 (91.9%) eligible patients with available assessment were judged clinically cured or improved at the end of observation. ConclusionIn clinical practice, dalbavancin was used in diabetic patients to treat ABSSSIs and other difficult-to-treat infections with a favourable safety profile and a high rate of positive clinical responses.

Dexamethasone-Associated Hyperglycemia is Not Associated With Infectious Complications After Total Joint Arthroplasty in Diabetic Patients

BackgroundPostoperative infection is a devastating complication of total joint arthroplasty (TJA). Perioperative use of dexamethasone in patients who have diabetes mellitus (DM) remains controversial due to concern for increased infection risk. This study aimed to evaluate the association between dexamethasone and infection risk among patients who have DM undergoing TJA. MethodsThis was a retrospective cohort study conducted on adult patients who underwent primary, elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) between January 2016 and December 2021 using a large national database. We identified 110,568 TJA patients (TKA: 66.6%; THA: 33.4%), 31.0% (34,298) of which had DM. Patients who received perioperative dexamethasone were compared to those who did not. The primary end points were the 90-day risk of postoperative periprosthetic joint infection, surgical site infection (SSI), and other non-SSI (urinary tract infection, pneumonia, sepsis). ResultsWhen modeling the association between dexamethasone exposure and study outcomes while accounting for the interaction between dexamethasone and morning blood glucose levels, dexamethasone administration conferred no increased odds of postoperative periprosthetic joint infection nor SSI in diabetics. However, dexamethasone significantly lowered the adjusted odds of other postoperative infections in diabetic patients (TKA: adjusted odds ratio = 09, 95% confidence interval = 0.8 to 1.0, P = .030; THA: adjusted odds ratio = 0.7, 95% confidence interval = 0.6 to 0.9, P = .001); specifically in patients with morning blood glucose levels between 110 to 248 mg/dL in TKA and ≤ 172 mg/dL in THA. ConclusionsThis study provides strong evidence against withholding dexamethasone in diabetic patients undergoing TJA based on concern for infection. Instead, short-course perioperative dexamethasone reduced infection risk in select patients. The narrative surrounding dexamethasone should shift away from questions about whether dexamethasone is appropriate for diabetic patients, and instead focus on how best to optimize its use.

Machine learning for predicting hepatitis B or C virus infection in diabetic patients

Highly prevalent hepatitis B and hepatitis C virus (HBV and HCV) infections have been reported among individuals with diabetes. Given the frequently asymptomatic nature of hepatitis and the challenges associated with screening in some vulnerable populations such as diabetes patients, we conducted an investigation into the performance of various machine learning models for the identification of hepatitis in diabetic patients while also evaluating the significance of features. Analyzing NHANES data from 2013 to 2018, machine learning models were evaluated; random forest (RF), support vector machine (SVM), eXtreme Gradient Boosting (XGBoost), and least absolute shrinkage and selection operator (LASSO) along with stacked ensemble model. We performed hyperparameter tuning to improve the performance of the model, and selected important predictors using the best performance model. LASSO showed the highest predictive performance (AUC-ROC = 0.810) rather than other models. Illicit drug use, poverty, and race were highly ranked as predictive factors for developing hepatitis in diabetes patients. Our study demonstrated that a machine-learning-based model performed optimally in the detection of hepatitis among diabetes patients, achieving high performance. Furthermore, models and predictors evaluated from the current study, we expect, could be supportive information for developing screening or treatment methods for hepatitis care in diabetes patients.

Outcomes of Surgically Treated Pilon Fractures: A Comparison of Patients with and without Diabetes.

Compare systemic complications, fracture healing related complications, and reoperation rates for pilon fractures in patients with and without diabetes. Retrospective cohort study. National administrative claims database with patient records. Patients from the years 2016 to 2020 with surgically treated closed or open pilon fractures. Patients with either closed or open pilon fractures with diabetes were compared to those without diabetes. Subgroup analysis was performed on diabetic patients with and without neuropathy. Postoperative systemic complications at 90 days, fracture healing complications at 90 days and 1 year, and reoperative rates at 90 days and 1 year. 2,654 (31.4%) patients with closed fractures and 491 (28.7%) patients with open fractures had a diagnosis of diabetes. In both open and closed fractures, we identified significantly higher rates of acute kidney injury, cardiac arrest, and surgical site infection in diabetic patients compared to non-diabetic patients. Additionally, we found significantly higher rates of below knee amputations in diabetic patients. Diabetic patients with closed fractures had significantly higher rates of wound healing related reoperations. Patients with advanced diabetic disease, as suggested by the presence of neuropathy, had higher rates of nonunions and post-traumatic arthritis. The data presented here provides updated estimates on complication rates in pilon fractures using large sample size. Additionally, our work identifies differences in outcomes for patients with and without diabetes following pilon fracture surgery. Our data suggests that patients with severe diabetes are prone to higher rates of healing complications and may benefit from additional therapeutic support. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Humoral response after breakthrough SARS-CoV-2 infection in type 2 diabetes mellitus patients

Abstract Type 2 diabetes mellitus (T2DM) remains an important public health problem in both developing and developed countries. In addition, the recent COVID-19 pandemic has revealed furthel risks for diabetes patients in terms of symptoms and disease progression. Higher mortality and morbidity are related to the complexity of the pathology of this chronic underlying disease, which negatively affects the immune response to the SARSCoV-2 virus. The humoral response plays an important role in the eradication of the virus; thus, it was analyzed in vaccinated diabetics who underwent COVID-19, as well as in the control group. The aim of this study was to assess the prevalence and level of IgG antibodies raised against the nucleocapsid protein (NCP), S1 subunit receptor binding domain (RBD) and subunit Spike 2 (S2) subunit of the virus’s S protein using the Microblot Array test. The results demonstrated significantly lower prevalence and titers of anti-SARS antibodies in diabetic patients compared to the control group. In addition, antibody titers were negatively related to the duration of this chronic disease, body mass index (BMI), comorbidities and HbA1c concentration. Further research is needed to develop the best strategy for specific prevention of SARS-CoV-2 infection in diabetic patients.

Surgical Site Infections in Diabetic Patients: literature review

Diabetes mellitus is a chronic metabolic condition with severe repercussions in surgical treatment. One important component of this effect is the complex link between diabetes and Surgical Site Infections (SSI). Diabetes severely slows wound healing, owing to poor microvascular circulation, decreased collagen production, and diminished immunological responses. Diabetic patients are more likely to develop SSI as a result of variables such as hyperglycemia, neuropathy, obesity, and peripheral vascular disease. Staphylococcus aureus, Escherichia coli, and Enterococcus species are common bacterial infections that cause SSI in diabetics. Furthermore, this review emphasizes important biomarkers, such as C-reactive protein and procalcitonin, which provide indications for SSI in diabetics. Deep tissue involvement, sepsis, and extended hospitalization are among the consequences associated with these infections, which need quick and customized care measures. By focusing on both diabetes control and SSI prevention, healthcare practitioners may reduce the significant burden both conditions place on patients and the healthcare system, thereby improving outcomes for diabetic patients having surgical operations.

Role of NLRP3 inflammasome in diabetes and COVID-19 role of NLRP3 inflammasome in the pathogenesis and treatment of COVID-19 and diabetes NLRP3 inflammasome in diabetes and COVID-19 intervention.

2019 Coronavirus Disease (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). A "cytokine storm", i.e., elevated levels of pro-inflammatory cytokines in the bloodstream, has been observed in severe cases of COVID-19. Normally, activation of the nucleotide-binding oligomeric domain-like receptor containing pyrin domain 3 (NLRP3) inflammatory vesicles induces cytokine production as an inflammatory response to viral infection. Recent studies have found an increased severity of necrobiosis infection in diabetic patients, and data from several countries have shown higher morbidity and mortality of necrobiosis in people with chronic metabolic diseases such as diabetes. In addition, COVID-19 may also predispose infected individuals to hyperglycemia. Therefore, in this review, we explore the potential relationship between NLRP3 inflammatory vesicles in diabetes and COVID-19. In contrast, we review the cellular/molecular mechanisms by which SARS-CoV-2 infection activates NLRP3 inflammatory vesicles. Finally, we propose several promising targeted NLRP3 inflammatory vesicle inhibitors with the aim of providing a basis for NLRP3-targeted drugs in diabetes combined with noncoronary pneumonia in the clinical management of patients.

Particularities of Urinary Tract Infections in Diabetic Patients: A Concise Review.

Diabetes mellitus is a chronic disease that, untreated or poorly controlled, can lead to serious complications, reducing life expectancy and quality. Diabetic patients are more likely to develop infections, including many common infections, but also pathognomonic ones such as emphysematous pyelonephritis, malignant otitis externa, mucormycosis and Fournier's gangrene. Considering the fact that diabetic patients experience more frequently urinary tract infections (UTIs) with a worse prognosis than non-diabetic people, we conducted a review study based on data in the literature, following the particularities of UTIs in this group of patients, the risk factors, the mechanisms involved and the challenges in their management. The findings highlight that UTI in diabetic patients have some particularities, including a more frequent evolution to bacteremia, increased hospitalizations, and elevated rates of recurrence and mortality than non-diabetic patients. The possible risk factors identified seem to be female gender, pregnancy, older age, UTI in the previous six months, poor glycemic control and duration of diabetes. The mechanisms involved are related to glucosuria and bladder dysfunction, factors related to bacterial strains and host response. The bacterial strains involved in UTIs in diabetic patients and their antibiotic susceptibility profile are, with some exceptions, similar to those in non-diabetic people; however, the antimicrobial agents should be carefully chosen and the duration of the treatment should be as those required for a complicated UTI. The data related to the risk of developing UTIs in patients treated with SGLT-2 inhibitors, a new class of oral hypoglycaemic agents with cardiovascular and renal benefits, are controversial; overall, it was evidenced that UTIs occurred at the initiation of the treatment, recurrent infection was uncommon and the majority of UTIs responded to treatment with standard antibiotics. Moreover, interruption or discontinuation of SGLT-2 inhibitor as a result of UTI was rare and SGLT-2 inhibitors did not increase the risk of severe infections such as urosepsis and pyelonephritis.

Metformin reduces the risk of developing influenza A virus related cardiovascular disease

This study investigated the drug repositioning potential of metformin for cardiovascular risk due to influenza A virus infection. Statistical analysis was performed to analyze factors related to the risk of death after IAV infection in diabetic patients. Through in vitro and in vivo experiments, the effect of metformin on influenza A virus infection in non-diabetic conditions was analyzed. In logistic regression analysis, influenza vaccination (OR = 0.378, p-value = 0.007, 0.186 < 95% C·I < 0.768) and metformin treatment (OR = 0.380, p-value = 0.016, 0.173 < 95% C·I < 0.835) were associated with a decreased influenza-related mortality in diabetic patients. In vitro and in vivo studies showed that viral replication and influenza A virus-induced cytokine expression were inhibited by metformin. In particular, MCP-1 and IP-10, cytokines related to cell infiltration and cardiovascular disease development, were significantly reduced by metformin under influenza A virus infection condition. As a result, the acute exacerbation of atherosclerosis caused by influenza A virus in mouse aorta was inhibited by metformin. In addition, we found that regulation of AKT/MAPK signaling plays an important role in the mechanism of metformin. In conclusion, we demonstrated the potential and mechanism of metformin as a treatment for acute exacerbation of atherosclerosis caused by influenza A virus infection.

Investigating the etiological agents of urinary tracts infection in diabetic patients in inpatients and outpatients

Investigating the etiological agents of urinary tracts infection in diabetic patients in inpatients and outpatients

WTP8.4 Head and Neck Surgical Site Infections: A Quality Improvement Project

Abstract Aim Audit incidence of Surgical Site Infection (SSI) and early post-operative infection in open head and neck surgery in a tertiary centre and identify opportunities for improvement. Method We performed two 6-month audit cycles of rates of post-operative infection in elective open head and neck surgery against national rates. Cycle 1 was from August 2021-January 2022, and Cycle 2 from March-September 2022. Between cycles we introduced a flow-chart antibiotics prophylaxis protocol as an improvement measure and presented findings at a local meeting. Results 172 open head and neck operations were performed in Cycle 1. 7 patients developed SSIs. 169 open head and neck operations were performed in Cycle 2. 6 patients developed SSIs. Cycle 1 included 14 diabetic patients, of whom 7 received prophylactic antibiotics. Cycle 2 included 19 diabetic patients, of whom 16 received prophylactic antibiotics. In Cycle 1, 2 diabetic patients developed early post-operative infections, one of which was an SSI, compared with 0 in Cycle 2. SSI was more likely in patients who had surgical drains placed (8 out of 94 patients with drains, p = 0.008498*) and prophylactic antibiotic practice in this group was inconsistent in both cycles. Conclusion Our tertiary centre had comparable rates of SSI to national standards. We identified low rates of prophylactic antibiotic prescription for patients with diabetes and introduced a prophylaxis protocol which, despite not reaching statistical significance, appears to have improved rates of infection in diabetic patients. Additional changes should be introduced to reduce rates of infection in patients with surgical drains.

Dose Dependent Effect of Sulfamethoxazole on Inhibiting KATP Channel of Mouse Pancreatic β Cell.

Sulfamethoxazole (SMX) is widely used as an antibiotic in the clinical application with side effects of hypoglycemia. This is because SMX contains the sulfonamide structure, which closes ATP-sensitive potassium (KATP) channels and induces insulin secretion. However, there are no detail reports that measure the effective dose that can close KATP channels and induce insulin secretion. In this study, whole-cell patch clamp recording was utilized to measure the effect of SMX on KATP channel activity on pancreatic β cells. Also, the static incubation assay with mice islets was assessed to measure the insulin secretion capacity of SMX. SMX was shown to inhibit the KATP channel in pancreatic β cell membrane and induce insulin secretion in relatively high concentration. The half maximal inhibitory concentration (IC50) for KATP channel activity of SMX was .46 ± .08mM. It was also shown that a near IC50 concentration of SMX (.5mM) was able to nearly fully block the KATP channel when simultaneously applied with low concentration sulfonylurea, tolbutamide (.01mM). Our present data provide important information for the clinical use of SMX to treat infection in diabetic patients using sulfonylureas.

Determination of Bacteriological Profile of Antimicrobial Susceptibility Testing among Diabetic Patients with Urinary Tract Infections in Shendi, Sudan

Background: Urinary tract infection is a widespread microbial disease and 2nd most disease in women due to the anatomy of women type 2 diabetes is a high risk of infection of the urinary tract. Objective: To identify the agent that causes urinary tract infections in diabetic patients, select the best antibiotic, and assess the types of diabetes that are connected with urinary tract infections. Materials and Methods: From May to August 2018, a hospital-based cross- sectional study was carried out. According to the established methodology, urine samples were obtained for culture and identification. All isolates underwent an antimicrobial susceptibility test (AST) using the Kirby-Bauer disk diffusion method. The Statistical Package for the Social Science (SPSS) version 20 was used to import the data from Epi-data version 3.2.1. Results: The study's findings indicated that E. coli is the most prevalent bacterium, with a prevalence of approximately (30.2%). It is followed by K. pneumoniae (26.3%), and then by Staphylococcus aureus and Saprophiticus in percentage (15%). Gentamicin has a high rate of antibiotic sensitivity (approximately 36%), while Ceftazidime has a high rate of antibiotic resistance (about 35%). Around (52%) of people are resistant to Ceftriaxone and Cloxacillin. Conclusions: There was a high rate of UTI in diabetes patients. Female diabetics were more likely to experience UTIs than male diabetics.E. coli and K. pneumoniae species making up the majority of isolates. The isolated pathogens were highly susceptible to Gentamicin, Cloxacillin, and Ceftriaxone. These findings demonstrate the importance of glycemic management in diabetics for reducing UTIs, regardless of age or sex. By treating UTIs with the appropriate antimicrobial medications and monitoring the antimicrobial susceptibility patterns of isolated microorganisms, antibiotic-resistant urinary organisms can be managed.

Metagenomic next-generation sequencing for pulmonary infections diagnosis in patients with diabetes

BackgroundDiabetes mellitus is a major cause of high mortality and poor prognosis in patients with pulmonary infections. However, limited data on the application of metagenomic next-generation sequencing (mNGS) are available for diabetic patients. This study aimed to evaluate the diagnostic performance of mNGS in diabetic patients with pulmonary infections.MethodsWe retrospectively reviewed 184 hospitalized patients with pulmonary infections at Guizhou Provincial People’s Hospital between January 2020 to October 2021. All patients were subjected to both mNGS analysis of bronchoalveolar lavage fluid (BALF) and conventional testing. Positive rate by mNGS and the consistency between mNGS and conventional testing results were evaluated for diabetic and non-diabetic patients.ResultsA total of 184 patients with pulmonary infections were enrolled, including 43 diabetic patients and 141 non-diabetic patients. For diabetic patients, the microbial positive rate by mNGS was significantly higher than that detected by conventional testing methods, primarily driven by bacterial detection (microbes: 95.3% vs. 67.4%, P = 0.001; bacteria: 72.1% vs. 37.2%, P = 0.001). mNGS and traditional tests had similar positive rates with regard to fungal and viral detection in diabetic patients. Klebsiella pneumoniae was the most common pathogen identified by mNGS in patients with diabetes. Moreover, mNGS identified pathogens in 92.9% (13/14) of diabetic patients who were reported negative by conventional testing. No significant difference was found in the consistency of the two tests between diabetic and non-diabetic groups.ConclusionsmNGS is superior to conventional microbiological tests for bacterial detection in diabetic patients with pulmonary infections. mNGS is a valuable tool for etiological diagnosis of pulmonary infections in diabetic patients.

Prevalence of genitourinary infection in diabetic patients treated with SGLT 2 inhibitors.

Genitourinary infections are common in Diabetes patients compared to the general population more so in patients with Sodium glucose co transporter 2 inhibitors (SGLT2i) treatment , So, we did a study to find the prevalence of genitourinary infection in T2DM patients treated with SGLT2i. One hundred and twenty patients receiving SGLT2i, who had signs and symptoms indicative of genitourinary infections were enrolled into the study. The mean age of presentation was 54.4 ± 7.7 years and percentage of males were 62 (51.66%). In this cohort, 72(60%) were treated with empagliflozin, 34(28.33%) with dapagliflozin and 14(11.66%) with canagliflozin. Twenty patients had genital mycotic infection and 4 had urinary tract infection. Female patients had higher incidence of infections than male patients with no statistically significant difference (P = ns). We did not find any significant correlation between age of the patient, gender, duration of disease and treatment, HbA1c, different types and dose of SGLT2i used with the incidence of genital mycotic infections (P = ns). We need to counsel the patients before starting SGLT2i regarding possible chance of getting genitourinary infection, proper genital hygiene, drinking plenty of water and consulting the doctor if any symptoms at the earliest.