Diabetes-associated infections: development of antimicrobial resistance and possible treatment strategies

Arch Microbiol. 2020 Jul;202(5):953-965. doi: 10.1007/s00203-020-01818-x. Epub 2020 Feb 3.

Abstract

Diabetes mellitus is associated with various types of infections notably skin, mucous membrane, soft tissue, urinary tract, respiratory tract and surgical and/or hospital-associated infections. The reason behind this frequent association with infections is an immunocompromised state of diabetic patient because uncontrolled hyperglycemia impairs overall immunity of diabetic patient via involvement of various mechanistic pathways that lead to the diabetic patient as immunocompromised. There are specific microbes that are associated with each type of infection and their presence indicates specific type of infections. For instance, E. coli and Klebsiella are the most common causative pathogens responsible for the development of urinary tract infections. Diabetic-foot infections commonly occur in diabetic patients. In this article, we have mainly focused on the association of diabetes mellitus with various types of bacterial infections and the pattern of resistance against antimicrobial agents that are frequently used for the treatment of diabetes-associated infections. Moreover, we have also summarized the possible treatment strategies against diabetes-associated infections.

Keywords: Antimicrobial resistance; Diabetes-associated surgical site infections; Diabetic-foot infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacteria / classification
  • Bacteria / drug effects*
  • Bacteria / isolation & purification
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Diabetes Complications / drug therapy
  • Diabetes Complications / microbiology*
  • Diabetes Mellitus / immunology*
  • Diabetes Mellitus / pathology
  • Drug Resistance, Bacterial / drug effects
  • Female
  • Humans
  • Hyperglycemia / pathology
  • Immunocompromised Host / immunology*
  • Male
  • Microbial Sensitivity Tests
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Bacterial Agents