Assoc. prof. I.I. Medvid, prof. L.S. Babinets, assoc. prof. I.I. Herasymets
I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine
Relevance. Diabetes mellitus affects approximately 12 % of the adult population and is a serious burden on the health care system. It affects about 463 million people worldwide. Patients with diabetes have higher colonization of the skin and mucous membranes with potential pathogens of bacterial complications. They also require hospitalization more often due to the presence of comorbid conditions, which increases the risk of nosocomial infections.
The aim is to analyze scientific literature sources regarding the frequency, etiology, pathogenesis, features of the clinical course, and possibilities for preventing the occurrence of nosocomial infections in disorders of carbohydrate metabolism.
Main content. Hyperglycemia and, especially, the dynamics of glycated hemoglobin are significantly correlated with the susceptibility to nosocomial infection. The pathogenetic explanations for the above include: weakening of skin and mucous barriers, development of systemic vasculo- and neuropathy, inhibition of phagocytosis, release of pro-inflammatory cytokines, and increased synergistic relationships between pathogens. The proportion of nosocomial urinary tract infections for people with diabetes is 37.2 %, bloodstream infections — 22.5 %, wound infections — 17.7 %, pneumonia — 14.9 %. The type of hypoglycemic therapy has an impact on vulnerability to nosocomial pathogens. A significantly lower level of infection has been found when using metformin, compared with sulfonylurea drugs or insulin.
Conclusion. The presence of diabetes in a hospitalized patient significantly increases his susceptibility to the development of nosocomial infection, primarily affecting the urinary systems. Early diagnosis, timely selection of effective hypoglycemic therapy, limited use of invasive procedures contribute to improving the prognosis and reducing the duration of inpatient treatment.
Key words: nosocomial infection, diabetes mellitus, hyperglycemia, pancreas, comorbidity.
https://doi.org/10.15407/internalmed2025.02.107
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