Abstract / Summary
Abstract Objective To investigate the association between diabetes mellitus (DM) as a comorbidity and antimicrobial resistance in septic patients with Staphylococcus aureus (S. aureus) pulmonary infection, with the aim of guiding early clinical antimicrobial therapy. Methods A retrospective cohort study was conducted using data from the MIMIC-IV database, analyzing 2072 adult septic patients with S. aureus pulmonary infection. Logistic regression, stepwise model building, and subgroup analyses were performed to assess the relationship between diabetes status and multidrug-resistant Staphylococcus aureus (MDRSA) infection in these septic patients. Results Septic patients with S. aureus pulmonary infection and DM exhibited a significantly higher incidence of MDRSA infection compared to those without DM (55.4 vs. 45.3%, p < 0.001). Multivariate analysis within subgroups revealed that the association remained significant (p < 0.05) in patients > 65 years old, males, non-emergency admissions, those without chronic pulmonary disease, those requiring mechanical ventilation, and those with a maximum SOFA score < 6. In subgroups where the p-value was non-significant (p > 0.05), the odds ratio (OR) consistently remained above 1. Conclusion Diabetes mellitus may be associated with increased antimicrobial resistance in septic patients with S. aureus pulmonary infection. Close monitoring of antimicrobial effectiveness and timely adjustment of antimicrobial regimens are warranted in these patients.