Analysis Of Clinical Features And Drug Resistance In Type 2 Diabetic Patients Complicated With Bloodstream Infections

Objective To study the clinical features, pathogens distribution and antimicrobial resistance in T2DM patients complicated with bloodstream infections, and to improve cognition of early diagnosis and treatment for clinical cases.Methods 115 T2DM patients complicated with bloodstream infections from January 2008 to December 2015 were retrospectively reviewed.Results A total of 115 clinical isolates were collected from the blood samples, of which gram negative organisms,gram positive organisms and Candida accounted for 69.6%,26.9% and 3.5%, respectively. Among 80 strains of gram negative organisms, in which 27 (33.8%) strains were ESBLs-producing isolates, the main isolates were Escheriehia coli(34strains) and Klebsiella pneumoniae(29 strains). MRSA and MRCNS accounted for 50.0% and73.3% of S. aureus and CNS. The top three primary infection sites were respiratory tract (41 cases), urinary tract (30 cases) and biliary tract (21 cases). Male T2DM patients complicated with bloodstream infections secondary to respiratory system infection were more than female patients, while female patients secondary to urinary tract infection significantly were more than male patients. Most of gram positive organisms were high resistant to penicillin and ampicillin while sensitive to vancomycin and teicoplanin. The resistance rates of Escheriehia coli and Klebsiella pneumoniae to ampicillin were 68.4% and 100%, respectively. No imipenem or meropenem resistant strains of Escheriehia coli and Klebsiella pneumoniae were found. The average level of C reactive protein and procalcitonin in T2DM patients complicated with bloodstream infections were 167.5±111.6 mg/L and 27.9± 19.7ng/ml, respectively.Conclusions C reactive protein and procalcitonin show clinical implications in monitoring early bloodstream infections in T2DM.Gram negative organisms were the main pathogens in T2DM patients complicated with bloodstream infections, especially Escheriehia coli and Klebsiella pneumoniae. Blood culture and drug sensitive test should be considered before clinical use of antibiotics.