Type 2 diabetes mellitus and antibiotic-resistant infections: A Systematic Review and meta-analysis
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Author(s)
Carrillo Larco, Rodrigo
Anza-Ramirez, Cecilia
Saal-Zapata, Giancarlo
Villarreal-Zegarra, David
Zafra-Tanaka, Jessica H
Type
Journal Article
Abstract
Background: Type 2 diabetes mellitus (T2DM) has been associated with infectious diseases; however, whether T2DM is associated with bacterial-resistant infections has not been thoroughly studied. We ascertained whether people with T2DM were more likely to experience resistant infections in comparison to T2DM-free individuals. Methods: Systematic review and random-effects meta-analysis. The search was conducted in Medline, Embase, and Global Health. We selected observational studies in which the outcome was resistant infections (any site), and the exposure was T2DM. We studied adult subjects who could have been selected from population-or hospital-based studies. I-squared was the metric of heterogeneity. We used the Newcastle-Ottawa risk of bias scale. Results: The search retrieved 3,370 reports, 97 were studied in detail and 61 (449,247 subjects) were selected. Studies were mostly cross-sectional or case-control; several infection sites were studied, but mostly urinary tract and respiratory infections. The random-effects meta-analysis revealed that people with T2DM were two-fold more likely to have urinary tract (OR= 2.42; 95% CI: 1.83-3.20; I-squared 19.1%) or respiratory (OR= 2.35; 95% CI: 1.49-3.69; I-squared 58.1%) resistant infections. Although evidence for other infection sites was heterogeneous, they consistently suggested that T2DM was 66associated with resistant infections. Conclusions: Compelling evidence suggests that people with T2DM are more likely to experience antibiotic-resistant urinary tract and respiratory infections. The evidence for other infection sites was less conclusive but pointed to the same overall conclusion. These results could guide empirical treatment for patients with T2DM and infections.
Date Issued
2021-12-09
Date Acceptance
2021-06-05
Citation
Journal of Epidemiology and Community Health, 2021, 76 (1), pp.75-84
ISSN
0143-005X
Publisher
BMJ Publishing Group
Start Page
75
End Page
84
Journal / Book Title
Journal of Epidemiology and Community Health
Volume
76
Issue
1
Copyright Statement
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
Wellcome Trust
Grant Number
214185/Z/18/Z
Subjects
infections
nutritional sciences
public health
Epidemiology
1117 Public Health and Health Services
1604 Human Geography
Publication Status
Published
Date Publish Online
2021-07-29