Epidemiology, microbiology, and diagnosis of infection in diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: A multicenter retrospective observational study

Kyosuke Takahashi, Norimichi Uenishi, Masamitsu Sanui, Shigehiko Uchino, Naoki Yonezawa, Tetsuhiro Takei, Norihiro Nishioka, Hirotada Kobayashi, Shunichi Otaka, Kotaro Yamamoto, Hideto Yasuda, Shintaro Kosaka, Hidehiko Tokunaga, Naoki Fujiwara, Takashiro Kondo, Tomoki Ishida, Takayuki Komatsu, Koji Endo, Taiki Moriyama, Takayoshi OyasuMineji Hayakawa, Atsumi Hoshino, Tasuku Matsuyama, Yuki Miyamoto, Akihiro Yanagisawa, Tadamasa Wakabayashi, Takeshi Ueda, Tetsuya Komuro, Toshiro Sugimoto, Yusuke Sasabuchi

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: We investigated the characteristics of infection and the utility of inflammatory markers in diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS). Methods: A multicenter, retrospective observational study in 21 acute-care hospitals was conducted in Japan. This study included adult hospitalized patients with DKA and HHS. We analyzed the diagnostic accuracy of markers including C-reactive protein (CRP) and procalcitonin (PCT) for bacteremia. Multiple regression models were created for estimating bacteremia risk factors. Results: A total of 771 patients, including 545 patients with DKA and 226 patients with HHS, were analyzed. The mean age was 58.2 (SD, 19.3) years. Of these, 70 tested positive for blood culture. The mortality rates of those with and without bacteremia were 14 % and 3.3 % (P-value < 0.001). The area under the curve (AUC) of CRP and PCT for diagnosis of bacteremia was 0.85 (95 %CI, 0.81–0.89) and 0.76 (95 %CI, 0.60–0.92), respectively. Logistic regression models identified older age, altered level of consciousness, hypotension, and higher CRP as risk factors for bacteremia. Conclusions: The mortality rate was higher in patients with bacteremia than patients without it. CRP, rather than PCT, may be valid for diagnosing bacteremia in hyperglycemic emergencies.

Original languageEnglish
Article number111713
JournalDiabetes Research and Clinical Practice
Volume212
DOIs
Publication statusPublished - 06-2024

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Fingerprint

Dive into the research topics of 'Epidemiology, microbiology, and diagnosis of infection in diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: A multicenter retrospective observational study'. Together they form a unique fingerprint.

Cite this