Diagnostic microbiology and infectious disease · 2026
Impact of HbA1c levels on time to blood culture positivity in bacterial bloodstream infections.
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Çubuk Fatih, Öz Murtaza, Öksüz Caner
Аннотация
PURPOSE: Poor glycemic control is associated with increased susceptibility to bloodstream infection (BSI), sepsis, and adverse outcomes. Time to blood culture positivity (TTP) is an early microbiological marker with potential clinical implications; however, its relationship with glycated hemoglobin (HbA1c) has not been previously clarified. This study investigated the clinical impact of HbA1c levels on TTP and outcomes in intensive care unit (ICU) patients evaluated for suspected BSI.
METHODS: This retrospective study included 904 ICU patients. Blood samples were inoculated into BACTEC Plus Aerobic/F and Anaerobic/F bottles and incubated in the BD BACTEC 9120 system. HbA1c levels were measured at admission using standardized laboratory methods.
RESULTS: Patients with HbA1c ≥6.5% demonstrated significantly shorter TTP for E. coli, K. pneumoniae, ACB complex, P. aeruginosa, S. aureus, and E. faecium (p<0.05). Higher HbA1c levels showed moderate negative correlations with TTP for E. coli, K. pneumoniae, ACB complex, S. aureus, and E. faecalis/faecium. Clinically, the 28-day mortality rate was markedly higher in patients with HbA1c ≥6.5% compared with those with lower HbA1c levels (17.3% vs. 6.2%, p<0.001). Patients with K. pneumoniae and ACB complex infections who died had significantly higher HbA1c levels compared with survivors (p<0.05). TTP was significantly shorter in deceased patients with E. coli, K. pneumoniae, and E. faecalis/faecium isolates (p<0.05).
CONCLUSIONS: Elevated HbA1c levels are associated with shorter TTP and increased mortality in ICU patients with BSI. HbA1c may serve as a readily available clinical marker to aid early risk stratification and interpretation of TTP in critically ill patients.
METHODS: This retrospective study included 904 ICU patients. Blood samples were inoculated into BACTEC Plus Aerobic/F and Anaerobic/F bottles and incubated in the BD BACTEC 9120 system. HbA1c levels were measured at admission using standardized laboratory methods.
RESULTS: Patients with HbA1c ≥6.5% demonstrated significantly shorter TTP for E. coli, K. pneumoniae, ACB complex, P. aeruginosa, S. aureus, and E. faecium (p<0.05). Higher HbA1c levels showed moderate negative correlations with TTP for E. coli, K. pneumoniae, ACB complex, S. aureus, and E. faecalis/faecium. Clinically, the 28-day mortality rate was markedly higher in patients with HbA1c ≥6.5% compared with those with lower HbA1c levels (17.3% vs. 6.2%, p<0.001). Patients with K. pneumoniae and ACB complex infections who died had significantly higher HbA1c levels compared with survivors (p<0.05). TTP was significantly shorter in deceased patients with E. coli, K. pneumoniae, and E. faecalis/faecium isolates (p<0.05).
CONCLUSIONS: Elevated HbA1c levels are associated with shorter TTP and increased mortality in ICU patients with BSI. HbA1c may serve as a readily available clinical marker to aid early risk stratification and interpretation of TTP in critically ill patients.