Patients with diabetes are at increased risk of blood infections caused by a microbe called enterobacteria, Danish researchers have found. Frequently, these infections start in the urinary tract before spreading to the blood.

“Diabetic persons with signs and symptoms of urinary tract infection or (blood infections) should be told to seek medical care promptly,” Dr. Reimar W. Thomsen said, “and physicians should keep a high level of suspicion for these infections if the patient has diabetes.”

Thomsen from Aarhus University Hospital in Aalborg and colleagues examined diabetes as a risk factor for enterobacterial blood infections in a study involving 1317 patients with blood infections and 13,170 comparison subjects without infection.

Patients with diabetes were three times as likely to develop enterobacterial blood infections as were patients without diabetes, the investigators report in the medical journal Clinical Infectious Diseases. Diabetics under 65 years of age and those who were female were at the highest risk.

The authors also found that these infections were more deadly in diabetics than non-diabetics. For example, after 30 days of infection, 17 percent of diabetics had died compared with 13 percent of non-diabetics.

“We conclude that diabetes has a considerable public health impact on the risk for and prognosis of enterobacteria (blood infections) acquired in the community,” the investigators write. “Preventive measures for diabetic patients might include increased surveillance and avoidance of well-known risk factors for urinary tract infections.”

In addition to the treatments that would be applied to any patient with enterobacteria blood infections, Thomsen emphasized that control of blood sugar is very important for diabetic patients.

The researchers are currently investigating the effect that diabetes has on blood infections caused by other microbes.

SOURCE: Clinical Infectious Diseases, February 15, 2005.