The role of diabetes mellitus in patients with bloodstream infections

BACKGROUND: Since diabetes mellitus predisposes to infection, we evaluated whether diabetes increases the risk of bloodstream infection and worsens its outcome. METHODS: During a 4-year period 71 diabetic and 252 non-diabetic patients with bloodstream infection were included. Risk factors for death were assessed by univariate and multivariate analysis. RESULTS: Bloodstream infection was more frequent in diabetics than in non-diabetics (25.8/1000 admissions vs. 5.8/1000 admissions, p 20 mmol/L (3.9 [1.7-22]), ICU stay (7.1 [2-25]), mechanical ventilation (8.4 [1.2-57]) and chronic renal/hepatic failure (8.2 [1.6-43]) as significant risk factors. Hyperglycaemia (4.3 [3.4-5.2]) and ICU stay (3.3 [1.9-4.9]) remained significant in multivariate analysis. CONCLUSIONS: Diabetics had a 4.4-fold higher risk of bloodstream infection, were more prone to sepsis of unknown origin and had more septic complications than non-diabetics. The mortality rate was similar in the two groups.