1. Associations of diabetes mellitus with orthopaedic infections
- Author
-
Mohamed Abdul-Basit Al-Mayahi, Hermès Howard Miozzari, Bénédicte Anne De Kalbermatten, Anais Cian, Benjamin Kressmann, Peter Rohner, Michaël Egloff, Sarah Malacarne, Jafaar Jafaar, and Ilker Uçkay
- Subjects
Male ,0301 basic medicine ,Diabetes Complications/epidemiology ,Soft Tissue Infections/complications/epidemiology ,Switzerland/epidemiology ,0302 clinical medicine ,Gram-Negative Bacterial Infections/complications/epidemiology ,Risk Factors ,Epidemiology ,Prevalence ,030212 general & internal medicine ,Young adult ,ddc:616 ,Aged, 80 and over ,ddc:617 ,biology ,Coinfection ,Osteomyelitis/complications/epidemiology ,Medical record ,Osteomyelitis ,General Medicine ,Middle Aged ,University hospital ,Hospitalization ,C-Reactive Protein ,Infectious Diseases ,Diabetes Mellitus/epidemiology ,Female ,Switzerland ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Prosthesis-Related Infections ,Adolescent ,030106 microbiology ,Diabetes Complications ,C-Reactive Protein/analysis ,Young Adult ,03 medical and health sciences ,Diabetes mellitus ,Internal medicine ,Diabetes Mellitus ,medicine ,Coinfection/epidemiology ,Humans ,Arthritis/complications/epidemiology ,Aged ,General Immunology and Microbiology ,business.industry ,Arthritis ,Soft Tissue Infections ,C-reactive protein ,medicine.disease ,Prosthesis-Related Infections/complications/epidemiology ,Surgery ,biology.protein ,Gram-Negative Bacterial Infections ,business - Abstract
Clinical experience suggests that a high proportion of orthopaedic infections occur in persons with diabetes.We reviewed several databases of adult patients hospitalized for orthopaedic infections at Geneva University Hospitals from 2004 to 2014 and retrieved 2740 episodes of infection.Overall, diabetes was noted in the medical record for 659 (24%) of these cases. The patients with, compared with those without, diabetes had more than five times more foot infections (274/659 [42%] vs 155/2081 [7%]; p0.01) and a significantly higher serum C-reactive protein level at admission (median 96 vs 70 mg/L; p0.01). Diabetic patients were older (median 67 vs 52 years; p0.01), more often male (471 [71%] vs 1398 [67%]; p = 0.04), and had more frequent polymicrobial infections (219 [37%] vs 353 [19%]; p0.01), including more gram-negative non-fermenting rods (90 [15%] vs 168 [9%]; p0.01). Excluding foot infections from these analyses did not change the statistically significant differences. Diabetes was present in 17% of all infected orthopaedic patients without foot involvement. In Geneva canton, the overall prevalence of diabetes is estimated at 5.1%, while we have found that the prevalence is 13% in our hospitalized adults.Diabetes is present in 24% of all adult patients hospitalized for surgery for an orthopaedic infection, a prevalence that is several times higher than for the general population and twice as high as that for the population of hospitalized patients. Compared with non-diabetics, patients with diabetes have significantly more infections that are polymicrobial, including gram-negative non-fermenting rods.
- Published
- 2015
- Full Text
- View/download PDF