Pneumonia in Diabetics: Clinico-Bacteriological Profile and Outcome
Dr. Sayali Bhambar, Pranav Deore, Rahul Rathod, Smit Janrao
Introduction: The present study was thus planned to study and compare pneumonia in diabetics and non-diabetics with respect to clinical presentation, bacteriological profile, laboratory parameters, complications and prognosis.
Materials & Methods: A total of 50 consecutive diabetic subjects with confirmed pneumonia were included in the study after informed consent (Study Group- SG). A similar number of non-diabetic controls were also taken (Control Group – CG). Detailed clinical history, general examination and relevant investigations were carried out for all patients and noted down in a pre-designed pro-forma. Relevant investigations were carried out in all patients including sputum gram staining, Chest X-ray and sputum and blood culture. Patients were treated as per standard hospital protocol and were followed up after 2 weeks to assess symptomatic improvement and for repeating chest radiograph.
Results: The average age in SG was 57.93±9.71 yrs and in CG were 56.90±11.83 yrs (p-0.613). Most of the patients in both groups were males (78% in CG and 60% in SG; p-0.39). Multilobe involvement (> 2 zones involvement in chest x- ray) was more common in SG (40% in CG vs. 70% in SG) which is statistically significant (p<0.05). On Gram staining, Gram positive cocci were significantly more (p<0.05) in CG in comparison with SG (48% vs. 16%) while a combination of GPC/GNB was significantly more in SG than CG (30% vs. 6%). More number of mortalities were seen in diabetics (24%) in comparison with non-diabetics (10%). Patients in diabetic group were significantly more among PSI class IV and V (60% vs 34%) in comparison with non-diabetics, who were predominantly among PSI class I (P < 0.05).
Conclusion: In patients with pneumonia, Diabetes Mellitus is associated with polymicrobial etiology, multilobe involvement, increased ICU admissions, increased severity in the form of high PSI score and mortality.