Clinical Features and Treatment Strategies for Infectious Diseases in Patients with Diabetes Mellitus

Abstract

The clinical features of 207 patients with diabetes mellitus who required hospitalization for the treatment or prevention of infections were investigated to consider effective strategies for the treatment of infections in diabetic patients. The most frequent type of infection was respiratory infection (41%), followed by urinary tract infection (24%) and skin/soft tissue infections (17%). When the subjects were divided by the leukocyte count and serum CRP level into mild, moderate and severe groups, the severe group had higher random blood glucose levels and required higher daily total insulin doses. There was also a significant association between the severity of infection and the incidence of ketosis or ketoacidosis. The most common causative microorganisms of pneumonia in the diabetic patients were methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonas aeruginosa and Mycoplasma (in descending order). Because severe infections complicating diabetes mellitus can induce marked elevation of the blood glucose levels as well as increase the risk of complication by ketosis or ketoacidosis, diabetic patients with infections need immediate amelioration of the abnormal glucose metabolism, identification of the pathogenic microorganism and treatment with appropriate antibiotics.