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Volume 13 Issue 10 (October) 2024

Original Articles

Assessment of Bacterial Load and Severity in the Respiratory Tract of Individuals with Diabetes Mellitus (DM): A Comparative Analysis by Sex and Age groups
Dr. Sachin Sharma, Dr. Ishani Deshmukh, Dr. Sudarshan Gupta, Dr. Arisha Javed, Dr. Kaushilya Kaurav, Dr. Shyam Shukla, Dr. Sandhya Gupta

Aim: To evaluate distribution of various bacteriological infection and there severity in different age and gender of respiratory tract infections in people with diabetes mellitus. Materials and Methods: In this cross-sectional analytical study, a total of 80 cases of Diabetes Mellitus (DM) with lower respiratory tract infections (LRTI) were analyzed to explore the association between DM and LRTI. The study population included 80 patients, selected randomly from all age groups and both sexes, who were admitted to tertiary care hospitals (Respiratory medicine wards) within our region. Patients included in the study were either known cases of DM or were diagnosed for the first time and presented with LRTI as determined by clinical and radiological findings. Routine laboratory investigations were performed, including haemoglobin levels, total and differential WBC counts, random and fasting blood sugar levels, post-prandial blood sugar levels, renal and liver function tests, urine routine and microscopic examination, erythrocyte sedimentation rate (ESR), chest X-ray, and two sputum smear examinations for Acid-Fast Bacilli (AFB) using Ziehl-Neelsen stain and culture-sensitivity tests of sputum. Results: The mean age of onset of DM in the study population was 45 years, with a standard deviation of 15 years, indicating a wide range of onset ages. The average haemoglobin level was 12.5 g/dL with a standard deviation of 1.5, which is within the normal range for adults. The total WBC count averaged 9.0 x10^9/L with a standard deviation of 2.0. Differential WBC count showed the following averages: neutrophils at 70% (±10), lymphocytes at 20% (±5), monocytes at 6% (±2), and eosinophils at 4% (±1). Blood sugar levels were elevated among the patients, with the mean random blood sugar at 250 mg/dL (±50), fasting blood sugar at 150 mg/dL (±30), and post-prandial blood sugar at 220 mg/dL (±40). The erythrocyte sedimentation rate (ESR), an indicator of inflammation, averaged 30 mm/hr with a standard deviation of 10. Radiological findings from chest X-rays showed that 31.25% (25 patients) had consolidation, 43.75% (35 patients) had infiltrates, and 12.5% (10 patients each) had either cavitation or pleural effusion. Sputum smear tests for Acid-Fast Bacilli (AFB) were positive in 25% (20 patients) of the cases, while the remaining 75% (60 patients) tested negative. Out of these patients CT scan performed in 30 patients. CT scan findings, revealed consolidation in 12.5% (10 patients), infiltrates in 18.75% (15 patients), and cavitation in 6.25% (5 patients). Conclusion: In the study revealed that Streptococcus pneumoniae is the most common pathogen causing severe respiratory tract infections in diabetic patients, followed by Klebsiella pneumoniae and Staphylococcus aureus. Less severe infections were associated with Haemophilus influenzae and Moraxella catarrhalis. The majority(56.25%) of lower respiratory tract infections (LRTIs) occurred in male patients aged 41-60 years, predominantly from urban areas and with middle socio-economic status. Clinical findings indicated elevated blood sugar levels and infection, underscoring the need for focused preventive and treatment strategies, especially for at-risk diabetic populations.

 
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