Diabetes Mellitus and Multidrug-Resistant Gram-Negative Bacterial Infections in Critically Ill COVID-19 Patients: A Retrospective Observational Study.

ingentiumby ingentium

In Clinical Literature.

Publication date: May 08, 2025

Background: Diabetes mellitus (DM) is an independent risk factor for severe SARS-CoV-2 infection and is linked to higher incidences of infections and adverse outcomes in patients with DM. This study examines the association between DM and multidrug-resistant Gram-negative bacteria (MDR-GNB) in critically ill, intubated COVID-19 patients in the intensive care unit (ICU) and evaluates mortality rates and clinical factors contributing to unfavorable outcomes. Methods: This retrospective observational study included intubated COVID-19 patients diagnosed with secondary infections due to MDR-GNB. Patients were treated for acute respiratory distress syndrome (ARDS) in a tertiary care university hospital ICU between October 2020 and February 2022. Collected data included demographics, comorbidities, medication, and laboratory parameters including blood tests and culture samples. Results: Among 416 COVID-19 patients, 112 (26. 9%) had T2DM. Cultures from lower respiratory tract specimens revealed a significantly higher likelihood of isolating Acinetobacter baumannii in patients with DM (OR: 2. 18, 95% CI: 1. 40-3. 40, p < 0. 001), and DM is an independent predictor of isolation Acinetobacter baumannii in bronchial secretions of COVID-19 intubated patients (OR: 2. 046, 95% CI: 1. 256-3. 333. p < 0. 004). DM was not significantly associated with differences in length of stay (LOS) until discharge or death (HR: 0. 76, 95% CI: 0. 51-1. 12, p = 0. 16; HR: 0. 91, 95% CI: 0. 70-1. 19, p = 0. 50) or 28-day ICU mortality (OR: 1. 12, 95% CI: 0. 52-2. 41, p = 0. 77). Age was linked to an increased 28-day mortality risk in patients with DM (OR: 1. 10, 95% CI: 1. 02-1. 18, p = 0. 011). Conclusions: In critically ill intubated COVID-19 patients, DM emerged as a significant and independent predictor for the isolation of Acinetobacter baumannii from bronchial secretions, highlighting a key link between DM and specific multidrug-resistant pathogens, even though no broader association with MDR-GNB-related secondary infections was observed.

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Concepts Keywords
Acinetobacter COVID-19
Diabetes diabetes mellitus
February ICU
October multidrug-resistant Gram-negative pathogens
Unfavorable SARS-CoV-2

Semantics

Type Source Name
disease MESH Diabetes Mellitus
disease MESH Gram-Negative Bacterial Infections
disease MESH Critically Ill
disease MESH COVID-19
pathway REACTOME SARS-CoV-2 Infection
disease MESH infections
disease IDO bacteria
disease MESH secondary infections
disease MESH acute respiratory distress syndrome
disease IDO blood
disease MESH death
drug DRUGBANK Coenzyme M
disease MESH comorbidity
disease MESH hypertension
disease MESH dyslipidemia
disease MESH coronary artery disease
disease IDO infection
disease IDO infectivity
disease MESH hyperglycemia
pathway KEGG Viral replication
disease IDO replication
pathway REACTOME Glycolysis
disease MESH inflammation
pathway REACTOME Immune System
disease MESH Oxidative stress
pathway REACTOME Glucose metabolism
disease MESH respiratory failure
disease MESH complications
disease MESH acute kidney injury
disease MESH liver dysfunction
disease MESH thrombosis
disease MESH sepsis
disease MESH septic shock
drug DRUGBANK Vancomycin
disease MESH community acquired infections
disease MESH nosocomial infections
disease MESH gestational diabetes
disease IDO history
disease MESH chronic kidney disease
disease MESH anemia
drug DRUGBANK Metformin
drug DRUGBANK Acetylsalicylic acid
drug DRUGBANK Clopidogrel
drug DRUGBANK Acenocoumarol
disease MESH pneumonia
disease MESH urinary tract infections
disease IDO susceptibility
disease MESH hyperuricemia
drug DRUGBANK Creatinine
drug DRUGBANK Dextrose unspecified form
disease IDO pathogen
disease MESH Arrhythmia
disease MESH COPD
disease MESH Cancer
disease MESH Hypothyroidism
disease MESH Psychiatric Disorder
drug DRUGBANK Methionine
disease MESH benign prostatic hyperplasia
drug DRUGBANK Glucagon
drug DRUGBANK Pioglitazone
disease MESH leukocytosis

Original Article

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