Clinical and Epidemiological Profile of Multidrug-Resistant Klebsiella pneumoniae Infections in Patients With Type 2 Diabetes Mellitus

TL;DR

This study examines how multidrug-resistant Klebsiella pneumoniae infections affect people with type 2 diabetes, focusing on clinical outcomes and resistance patterns.

Contribution

The study provides insights into the clinical profile and antimicrobial resistance patterns of MDR Klebsiella pneumoniae in patients with type 2 diabetes.

Findings

Most isolates showed resistance to third-generation cephalosporins and fluoroquinolones.

Despite low in-hospital mortality, only a quarter of patients achieved microbiological resolution.

Poor glycemic control was common among patients with long-standing diabetes.

Abstract

The global convergence of antimicrobial resistance and type 2 diabetes mellitus (T2DM) presents significant clinical challenges. This retrospective cross-sectional study included 60 adult inpatients with T2DM and culture-confirmed multidrug-resistant (MDR) Klebsiella pneumoniae infections admitted between January 2022 and December 2024 at a tertiary care center in South India. The cohort had a mean age of 60.7 years, with a male predominance of 66.7% (40/60). Poor glycemic control was common (mean HbA1c 8.98%), and 51.7% (31/60) had long-standing diabetes (>10 years). Sepsis was the most frequent clinical presentation in 33.3% (20/60), followed by skin and soft tissue infections in 30.0% (18/60).

The isolates demonstrated high resistance to third-generation cephalosporins in 96.7% (58/60) and fluoroquinolones in 93.3% (56/60), while 45.0% (27/60) were carbapenem resistant. Polymyxin susceptibility was largely retained (98.3%, 59/60). The mean duration of hospital stay was 15.8 days. In-hospital mortality was low at 3.3% (2/60); however, microbiological resolution at discharge was documented in only 25.0% (15/60) of cases. These findings underscore the substantial morbidity associated with MDR Klebsiella pneumoniae infections in patients with T2DM despite low in-hospital mortality, highlighting the need for strengthened antimicrobial stewardship and optimized glycemic control strategies in this high-risk population. The objective of this study is to determine the clinical and demographic profiles of patients with multidrug-resistant Klebsiella pneumoniae infections among those with type 2 diabetes mellitus, as well as to describe antimicrobial resistance patterns and in-hospital clinical outcomes in this patient population.

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