Adult bacteremia. Comparative study between diabetic and non-diabetic patients

OBJECTIVE: To compare type of infection, microbiology, source, complications and outcome of bactermia in diabetic and non-diabetic patients in our teaching hospital. To study the risk factors associated with diabetic bacteremia's mortality and to compare our findings with those reported in the literatures.

METHODS: Retrospective study of all adult cases of bactermia admitted to King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, from January 1998 to January 1999.

RESULTS: Rate of bacteremia per 1000 admission was 23. We compared 71 episodes in 48 diabetics with 100 episodes in 77 non-diabetics. Diabetic patients were older than non-diabetics (mean age 61.08 versus 49.89 years, p <0.001). No statistically significant difference was found between the 2 groups in the type and source of infection. Klebsiella of urinary source was isolated from 37% episodes in diabetics versus 11% non-diabetics (p 0.03). Acute renal failure and septic shock were the 2 complications significantly developed in non-diabetics compared to diabetics (19% versus 7% and 13% versus 4%, p=0.02 and 0.05). Mortality due to bacteremia was 24% in diabetics and 44% in non-diabetics (p 0.007). Hospital acquired infections, presence of underlying malignancy, use of ventilators, development of septic shock and acute renal failure, were factors associated with high mortality in diabetic bacteremia.

CONCLUSION: Our results are comparable with those reported in the literatures. The better outcome observed in our diabetic bactermia could be due to adequate glycemic control during bacteremic episode and appropriate choice of empiric antibiotics.