Etiology of bloodstream infections in adult diabetic patients from a single tertiary hospital in southern Vietnam: a retrospective study

Diabetes mellitus (DM) is a significant risk factor for the development of bloodstream infections (BSIs), particularly in settings with a high burden of antimicrobial resistance (AMR). However, data availability in countries with low to middle incomes remains scarce. To describe the clinical characteristics, etiology, and AMR patterns of BSIs in patients with DM. An observational study was conducted on 99 adult diabetic patients with confirmed BSIs admitted to a tertiary hospital in southern Vietnam from January 2022 to May 2024. Information about clinical, laboratory, and microbiological findings was collected from electronic medical records. The median age was 60 years, and 55.6% were female. The most common foci of infection were urinary tract infections (19.2%) and deep abscesses (10.1%), while multiple infectious foci were identified in 16.2% of cases. Escherichia coli (53.5%), Klebsiella pneumoniae (15.2%), and Burkholderia pseudomallei (10.1%) were the predominant pathogens. Resistance to third-generation cephalosporins (3GCs) was observed in 64.7% of E. coli and 26.7% of K. pneumoniae isolates evaluated. Empirical antimicrobial treatment most commonly involved β-lactam/β-lactamase inhibitor combinations (51.5%) and carbapenems (33.3%). Intensive care was required for 20.2% of patients, and one fatality was reported. BSIs in diabetic patients in southern Vietnam are predominantly caused by gram-negative bacteria with a high rate of AMR, particularly to 3GCs. These findings highlight the need for early diagnosis, rational empirical therapy, and enhanced AMR monitoring to improve outcomes.