Analysis of markers associated with unfavorable clinical outcomes in the process of hospital therapy of community-acquired pneumonia in patients with type 2 diabetes mellitus


DOI: https://dx.doi.org/10.18565/therapy.2023.3.44-51

Karnaushkina M.A., Baisultanova R.E.-P., Osmanov E.M., Akaeva S.M., Elzhurkaeva L.R., Tokaeva M.R.

1) Peoples’ Friendship University of Russia of the Ministry of Science and Higher Education, Moscow; 2) I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University) of the Ministry of Health of Russia; 3) Consultative and Diagnostic Center No. 2 of the Department of Healthcare of Moscow of the Ministry of Healthcare of Russia; 4) A.A. Kadyrov Chechen State University of the Ministry of Science and Higher Education, Grozny; 5) Kh.M. Berbekov Kabardino-Balkarian State University of the Ministry of Science and Higher Education, Nalchik
Abstract. From chronic diseases diabetes mellitus (DM) C is one of the most significant risk factors for the development and severe course of community-acquired pneumonia (CAP) among the adult population.
The aim of the research is to find the factors associated with the ineffectiveness of initial empiric antibiotic therapy (ABT), with the development of acute diabetic and non-diabetic complications during CAP therapy among hospitalized patients with type 2 DM.
Material and methods. A prospective interventional single-center study involved 54 patients with CAP associated with type 2 diabetes mellitus. They were hospitalized in the Department of pulmonology of Sh.Sh. Ependiev Republican Clinical Hospital (Grozny) in the period from 01/01/2019 up to 07/01/2019.
Results. Among patients, an effective starting empiric ABT of EAP was observed in 46.3% (25/54), ineffective C in 53,7% (29/54) of cases. The factors associated with the ineffectiveness of the initial empiric ABT of EAP were identified. They include late hospitalization (p=0,027), gram-negative bacterial flora (p=0,028), presence of concomitant chronic diseases (p=0,032), chronic complications of DM (p=0,009), glycated hemoglobin at admission to the hospital ≥11% (p=0,01). Insulin therapy in anamnesis in this case plays a role of a protective factor (p=0,018). The severity of CAP (p=0,02), COPD (p=0,019), acute cerebrovascular accident in anamnesis (p=0,034), lack of effect from starting empirical ABT of CAP (p=0,008), glycated hemoglobin at admission ≥11% (p=0,037), experience of type 2 diabetes (p=0,049) are associated with the development of acute non-diabetic complications. The severity of CAP (p=0,025), unknown etiology of CAP (p=0,049), CKD (p=0,039), glycated hemoglobin at admission ≥11% (p=0,012), insulin therapy in anamnesis (p=0,02), acute non-diabetic (p=0,033) and chronic diabetic complications (p=0,048) are associated with the development of acute diabetic complications.
Conclusion. As a result of the study, factors associated with the ineffectiveness of the initial empiric ABT of CAP among hospitalized patients with type 2 diabetes, as well as factors associated with the development of acute diabetic and non-diabetic complications during CAP therapy, were identified.
Keywords: complications of diabetes mellitus, community-acquired pneumonia, antibiotic therapy, diabetes mellitus, risk factors
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About the Autors

Maria A. Karnaushkina, MD, professor, professor of the Department of internal medicine with a course of cardiology and functional diagnostics, Peoples’ Friendship University of Russia of the Ministry of Science and Higher Education. Address: 117198, Moscow, 6 Miklukho-Maklaya Str. E-mail: kar3745@yandex.ru. ORCID: https://orcid.org/0000-0002-8791-2920
Roza E-P. Baysultanova, postgraduate student of the Department of internal diseases with a course of cardiology and functional diagnostics, Peoples’ Friendship University of Russia of the Ministry of Science and Higher Education. Address: 117198, Moscow, 6 Miklukho-Maklaya Str. E-mail: rozapulm@gmail.com. ORCID https://orcid.org/0000-0001-6091-0637
Esedulla M. Osmanov, MD, professor, professor of the Department of public health and healthcare named after N.A. Semashko of F.F. Erisman Institute of public health, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)». Address: 119991, Moscow, 8/2 Trubetskaya Str. E-mail: osmanov@bk.ru. ORCID https://orcid.org/0000-0001-7493-2351
Salimat M. Akayeva, endocrinologist at Consultative and Diagnostic Center No. 2 of the Department of Healthcare of Moscow of the Ministry of Healthcare of Russia. Address: 107564, Moscow, 6 Millionnaya Str. E-mail: Aitemirovasalima@mail.ru. ORCID https://orcid.org/0000-0002-2052-6558
Lida R. Elzhurkaeva, assistant at the Department of normal topographic anatomy, A.A. Kadyrov Chechen State University of the Ministry of Science and Higher Education. Address: 364060, Grozny, 32 Sheripova Str. E-mail: lida.elzhurkaeva@bk.ru. ORCID https://orcid.org/0000-0003-2445-6849
Mata R. Tokaeva, 6th year student of the Faculty of medicine, Kh.M. Berbekov Kabardino-Balkarian State University of the Ministry of Science and Higher Education. Address: 360004, Nalchik, 173 Chernyshevskogo Str. E-mail: mata.tokaeva@mail.ru. ORCID https://orcid.org/0000-0002-1397-7991


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