Antibiotic Resistance Rates in Causative Agents of Infections in Diabetic Patients

Rising Concerns

Lyudmila Boyanova; Ivan Mitov


Expert Rev Anti Infect Ther. 2013;11(4):411-420. 

In This Article

Abstract and Introduction


The vicious cycle is that hyperglycemia (≥11.1 mmol/l) or other diabetes-associated factors facilitate or worsen the development of infections and vice versa, the infections deteriorate the glycemic control of the patients. Diabetic patients are prone to some infections, infection recurrences and poor outcomes. Immunocompromised state and frequent antibiotic use are associated with antibiotic resistance of the bacterial pathogens, such as Mycobacterium tuberculosis (in some studies), methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae, Gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii, bacteria in diabetic foot infections and different opportunistic and rare pathogens or multidrug-resistant strains. Prompt diagnostics and susceptibility testing, early and aggressive surgical and/or antibiotic therapy, and, importantly, good glycemic control are of utmost importance for treatment of antibiotic-resistant infections in diabetic patients.


Diabetes mellitus (DM) is a common, chronic, debilitating and sometimes fatal endocrine disease with constantly growing global prevalence. In 2011, about 366 million people suffered from DM, and in 2030, the number would rise to 552 million.[1]

DM encompasses Type 1 DM, which can be associated with autoimmune damage of the pancreatic β cells, Type 2 DM, resulting from insulin resistance and disorder of insulin secretion and gestational DM, which can progress to Type 2 DM in the years afterward.[2] Type 2 DM encompasses most (usually 90–95%) of all diabetic patients.[2] It is worrying that 26.9% of the people aged >65 years and 11.3% of those aged >20 years had diagnosed or nondiagnosed DM in the USA in 2011.[3]