Study of Microbial Profile, Sensitivity Pattern of Community-Acquired Pneumonia in Diabetic Patients and Correlation with Glycaemic Status

BackgroundPneumonia, an infection of the lung parenchyma, is classified into community-acquired pneumonia (CAP) and nosocomial pneumonia. CAP occurs in patients who have not been hospitalized or resided in long-term care facilities for more than 14 days before symptom onset. Diabetes mellitus (DM), an immunosuppressive condition, predisposes patients to severe infections, including pneumonia. Diabetic patients with CAP often encounter more virulent or atypical pathogens and show increased resistance to conventional antibiotics. This study aimed to identify the bacterial etiology of CAP in diabetic patients and assess their antibiotic sensitivity patterns. MethodsA descriptive cross-sectional study was conducted in the Department of Medicine, Shaheed Suhrawardy Medical College Hospital, Dhaka, from 29th December 2017 to 28th June 2018. A total of 100 diabetic patients with CAP were enrolled following a structured protocol that included history-taking, clinical examination, and relevant investigations. Sputum samples were analyzed using standard microbiological techniques. Data were processed and analyzed using SPSS version 22 and Microsoft Excel. Quantitative data were expressed as mean {+/-} standard deviation, while qualitative data were presented as frequency and percentage. ResultsThe majority of the patients (54%) were between 51-60 years, with a mean age of 49.7 {+/-} 9.23 years. Of the 100 cases, 62% were male, and 38% were female, with a male-to-female ratio of 1.6:1. High-grade fever, sweating, and cough were the most common symptoms. Sputum cultures revealed growth in 92% of samples. The predominant pathogens were Klebsiella pneumoniae (30.4%), Streptococcus pneumoniae (23.9%), and Staphylococcus aureus (13.0%). Antibiotic resistance was highest against ceftriaxone and amoxicillin, with variable sensitivity across isolates. ConclusionThe study concludes that poor glycemic control is associated with increased susceptibility to infections. Early detection, appropriate management, and strict glycemic control can reduce the burden of pneumonia in diabetic patients. Lay SummaryO_ST_ABSUnderstanding the Relationship Between Pneumonia and DiabetesC_ST_ABSPneumonia is a serious lung infection causing coughing, fever, and breathing difficulties. People with diabetes are more vulnerable to infections due to weakened immune systems. This study, conducted in Bangladesh, explores how diabetes affects the bacteria causing pneumonia and their resistance to antibiotics. Key FindingsO_LIThe most common bacteria in diabetic pneumonia patients were Klebsiella pneumoniae (30.4%), Streptococcus pneumoniae (23.9%), and Staphylococcus aureus (13.0%). C_LIO_LIAntibiotics that lost efficacy due to resistance were highest for ceftriaxone and amoxicillin. C_LIO_LIPoor blood sugar control led to more infections and antibiotic resistance. C_LI Why It MattersThese findings highlight the need for strict blood sugar control and careful antibiotic selection to reduce pneumonia risks in diabetic patients.