Diabetes mellitus as a risk factor for nosocomial pneumonia and associated mortality.
Review
Overview
abstract
BACKGROUND: Patients with diabetes mellitus (DM) are considered to be more susceptible to several types of infections, including community-acquired pneumonia. However, it is not clear whether DM is a risk factor for development of hospital-acquired pneumonia (HAP), an infection with considerable morbidity and mortality worldwide. METHODS: We searched PubMed for relevant publications that included data on the possible association between DM and HAP. Cohort studies, case-control studies and observational studies were included in this analysis. Two of the authors performed the literature search independently. RESULTS: We identified 84 studies designed to identify risk factors and predictors of mortality as a result of HAP. Of these, 13 studied patients in the ward or intensive care unit (ICU), 28 studied patients treated in the ICU only, and 44 studied patients with ventilator-associated pneumonia. Only 14 considered the role of DM for this nosocomial complication. The reviewed data suggest that DM is not a risk factor for development of HAP in patients who require ICU treatment. In addition, patients with DM are not at increased risk for development of ventilator-associated pneumonia. Moreover, DM is not a prognostic factor for mortality in patients with HAP based on data from two out of 84 identified studies that provided relevant information. CONCLUSIONS: There is a relative scarcity of studies examining DM as a potential risk factor for HAP. Our analysis of the available data supports the conclusion that DM is not a risk factor for development of HAP and mortality associated with this nosocomial infection.
