|
|
| www.smw.ch |
| Stoeckle M, Kaech C, Trampuz A, Zimmerli W. |
Swiss Med Wkly 2008;138(35–36):512–519
|
| Original article Peer reviewed article |
 |
| Summary Background: Since diabetes mellitus predisposes to infection, we evaluated whether diabetes increases the risk of bloodstream infection and worsens its outcome. Methods: During a 4-year period 71 diabetic and 252 non-diabetic patients with bloodstream infection were included. Risk factors for death were assessed by univariate and multivariate analysis. Results: Bloodstream infection was more frequent in diabetics than in non-diabetics (25.8/1000 admissions vs. 5.8/1000 admissions, p <0.0001). Urinary tract infection was the predominant source, and Escherichia coli the most frequent microorganism in both groups. Klebsiella pneumoniae was more frequent in diabetics than in non-diabetics (18% vs 5%, p <0.001). Whereas sepsis of unknown origin was more common in diabetics (14% vs. 6%, p <0.05), catheter-related bloodstream infection predominated in non-diabetics (3% vs 10%, p <0.05). Secondary septic foci (p <0.05) and disseminated intravascular coagulation (p <0.05) were more frequent in diabetics. The in-hospital mortality rate was similar in the two groups (18% vs. 14%). Univariate analysis (RR [CI 95%]) in diabetics revealed glycaemia >20 mmol/L (3.9 [1.7–22]), ICU stay (7.1 [2–25]), mechanical ventilation (8.4 [1.2–57]) and chronic renal/hepatic failure (8.2 [1.6–43]) as significant risk factors. Hyperglycaemia (4.3 [3.4–5.2]) and ICU stay (3.3 [1.9–4.9]) remained significant in multivariate analysis. Conclusions: Diabetics had a 4.4-fold higher risk of bloodstream infection, were more prone to sepsis of unknown origin and had more septic complications than non-diabetics. The mortality rate was similar in the two groups. |
Basel University Medical Clinic, Liestal, Switzerland Clinic of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Switzerland |
|
Copyright © 2008 EMH Swiss Medical Publishers Ltd. |
Top