Pathogens found in patients with acute cerebral infarction complicated by diabetes mellitus and nosocomial pulmonary infection, were commonly multidrug-resistant gram-negative bacilli, according to data published in BMC Infectious Diseases.
From August 2015 to December 2017, 172 pathogenic bacterial strains were identified in patients with acute cerebral infarction complicated by diabetes mellitus and nosocomial pulmonary infection at a single hospital. Drug sensitivity of the identified strains was subsequently assessed.
Gram-negative bacteria accounted for 75.6% of all pathogens causing pulmonary infection in hospitalized patients with acute cerebral infarction and 80% of patients with diabetes with cerebral infarction had lung infection associated with gram-negative bacteria, which was significantly higher than in patients who did not have diabetes (72.2%). The drug resistance rate in the patients with diabetes was also significantly higher than in the patients who did not have diabetes at 68.3% and 54.3%, respectively. Gram-positive bacteria only accounted for 19.1% of all pathogenic bacteria identified and the infection rate with these bacteria in patients with diabetes with cerebral infarction was 14.7%, lower than the 28.2% infection rate in patients who did not have diabetes. The fungal infection rate in patients with and without diabetes was 5.3% and 5.2%, respectively, with the fungi presenting high sensitivity to commonly used antifungal agents.
Based on these findings the investigators recommended that, “in addition to actively treating the primary disease, early prevention, early diagnosis and active treatment should be directly given against high-risk factors, such as diabetes, hypertension and heart disease, and respiratory tract management and drug resistance monitoring should be strengthened,” in patients with acute cerebral infarction. The aim is to suppress the growth trend of drug resistance, minimize the incidence of pulmonary infections, and improve the effectiveness of treatments and prognosis.
Liu YX, Cao QM, Ma BC. Pathogens distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes and nosocomial pulmonary infection. BMC Infect Dis. 2019;19:603.