Antimicrobial resistance and outcomes of community-onset bacterial bloodstream infections in patients with type 2 diabetes

Chung Huei Huang, Cheng Hsun Chiu, I. Wen Chen, Shih Yuan Hung, Cheng Wei Lin, Brend Ray Sea Hsu, Yu Yao Huang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

9 Scopus citations

Abstract

Objectives: Antimicrobial resistance of bacterial pathogens in the diabetic population with infection is seldom investigated. This study evaluated the antimicrobial resistance and outcomes of community-onset bloodstream infections (CO-BSIs) in patients with diabetes. Methods: From 2007–2014, 1271 monomicrobial CO-BSIs and 178 polymicrobial CO-BSIs were identified in patients with type 2 diabetes from three teaching hospitals in Taiwan. Antimicrobial-resistant strains of the ten most prevalent bacterial pathogens in monomicrobial CO-BSIs were recorded and were defined according to individual drug resistance. The 30-day mortality rate and factors associated with outcome were analysed. Results: Antimicrobial-resistant strains were found in 33.7% (379/1125) of monomicrobial CO-BSIs involving the 10 most prevalent pathogens. The leading pathogens in these monomicrobial CO-BSIs were Staphylococcus spp. (33.8%; 430/1271), Escherichia coli (20.9%; 266/1271) and Klebsiella spp. (9.6%; 122/1271); antimicrobial-resistant strains accounted for 61.9%, 18.4% and 10.7% of each, respectively. A higher overall 30-day mortality rate was observed for patients infected by antimicrobial-resistant strains compared with antimicrobial-susceptible strains (9.5% vs. 5.5%; P = 0.011, log-rank test). A lower serum albumin level was a predictor of mortality after adjusting for antimicrobial-resistant strains and C-reactive protein level. Conclusions: Antimicrobial-resistant bacterial pathogens pose a serious threat to diabetic patients with CO-BSIs owing to a higher risk of mortality.

Original languageEnglish
Pages (from-to)271-276
Number of pages6
JournalJournal of Global Antimicrobial Resistance
Volume15
DOIs
StatePublished - 12 2018

Bibliographical note

Publisher Copyright:
© 2018 The Author(s)

Keywords

  • Antimicrobial resistance
  • Community-onset bloodstream infection
  • Diabetes
  • Monomicrobial bacteraemia
  • Polymicrobial bacteraemia

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