Sepsis risk in diabetic patients with urinary tract infection

PLoS One. 2024 May 21;19(5):e0303557. doi: 10.1371/journal.pone.0303557. eCollection 2024.

Abstract

Background: Urinary tract infections (UTI) is a prevalent condition in those with diabetes, and in severe cases, it may escalate to sepsis. Therefore, it is important to analyze the risk variables associated with sepsis in diabetes individuals with UTI.

Methods: This research was a retrospective cross-sectional analysis. From January 2011 to June 2022, a group of individuals with diabetes were identified as having UTI at a tertiary hospital situated in Southeastern China. Patient data, including information on urine culture, was collected retrospectively from a clinical record database. The participants were categorized into the sepsis and non-sepsis groups. The risk variables were derived using both uni-and multiple- variable regression analysis.

Results: The research included 1919 patients, of whom 1106 cases (57.63%) had positive urine cultures. In total, 445 blood culture samples were tested, identifying 186 positive cases (41.80%). The prevalence of bacteria in urine and blood samples was highest for Escherichia coli and Klebsiella pneumoniae, respectively. Moreover, 268 individuals (13.97%) exhibited sepsis. The regression analysis indicated a positive correlation between sepsis and albumin (ALB)<34.35 g/L, C-reactive protein (CRP)>55.84 mg/L and white blood cell count (WBC) >8.485 X 109/L in diabetic cases with UTIs. By integrating the three aforementioned parameters, the area under the receiver operating characteristic curve was 0.809.

Conclusions: The early detection of sepsis in diabetic individuals with UTI may be achieved using a comprehensive analysis of CRP, WBC, and ALB test findings.

MeSH terms

  • Adult
  • Aged
  • C-Reactive Protein / analysis
  • C-Reactive Protein / metabolism
  • China / epidemiology
  • Cross-Sectional Studies
  • Diabetes Complications / epidemiology
  • Diabetes Complications / microbiology
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Klebsiella pneumoniae / isolation & purification
  • Leukocyte Count
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Sepsis* / complications
  • Sepsis* / epidemiology
  • Urinary Tract Infections* / complications
  • Urinary Tract Infections* / epidemiology
  • Urinary Tract Infections* / microbiology

Grants and funding

This study was supported by the Fundings from the Science and Technology Bureau of Jinhua (grant No. 2022-4-278 and 2023-3-031). The funders had a role in the data collection and analysis.