Antibiotic resistance rates in causative agents of infections in diabetic patients: rising concerns.

The vicious cycle is that hyperglycemia (≥11.1 mmol/l) or other diabetes-associated factors facilitate or worsen the development of infections and vice versa, the infections deteriorate the glycemic control of the patients. Diabetic patients are prone to some infections, infection recurrences and poor outcomes. Immunocompromised state and frequent antibiotic use are associated with antibiotic resistance of the bacterial pathogens, such as Mycobacterium tuberculosis (in some studies), methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae, Gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii, bacteria in diabetic foot infections and different opportunistic and rare pathogens or multidrug-resistant strains. Prompt diagnostics and susceptibility testing, early and aggressive surgical and/or antibiotic therapy, and, importantly, good glycemic control are of utmost importance for treatment of antibiotic-resistant infections in diabetic patients.