Objective: To investigate the types, pathogenic characteristics and influencing factors of diabetes mellitus with infectious diseases, and to provide evidence for clinical empirical selection of antibiotics. Methods: 377 patients with diabetes complicated with infection were selected as the subjects. According to the infection site,the subjects were divided into urinary system, skin and soft tissue, diabetic foot, digestive system and respiratory system. Gender, age, duration of diabetes, glycosylated hemoglobin, glycated albumin and pathogen culture were collected, and were analyzed by Chi square test and multivariate Logistic regression. Results: (1) Among diabetic patients with infectious diseases, urinary tract infection happens the most, followed by diabetic foot infection, respiratory infection, skin and soft tissue infection without foot, otorhinolaryngologic infection, digestive system infection, genital infection and wound infection. (2) Gram-negative bacteria accounted for 44.4%, Escherichia coli accounted for 30.3%, followed by gram-positive bacteria which accounted for 41.0%, and 24.7% was accounted by Staphylococcus, and fungi accounted for 5.6%. (3) Gender of women and the glycosylated hemoglobin over 9%, age exceeded 60 years old had more diabetic infection than the men and glycosylated hemoglobin below 9% or younger than 60 years old(P<0.05). The proportion of patients with diabetes complicated with infection was mainly 0-20 years of the duration of diabetes(P<0.05). (4) Multivariate Logistic regression analysis showed that with diabetic foot infection as a reference, patients with diabetes duration less than 10 years had higher risk of urinary tract infection, respiratory system soft tissue infection without foot and other site infections than those foot infection with diabetic. Men(OR=0.119) and glycosylated hemoglobin less than 7%(OR=0.371) had lower urinary tract infection risk than foot infection with diabetic. Conclusion: Diabetes may be accompanied by multiple systemic infections, with different location of infection and different flora distribution. Diabetes duration, gender and glycosylated hemoglobin level are related to type of diabetes mellitus with infectious diseases, all these factors should be fully considered when choosing antibiotic treatment empirically. |
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