This is a companion article to the CLP feature, “HAIs Are at Crisis Stage.”
Although most patients are unaware of their diabetic status when they are admitted to the hospital, having a high blood glucose level is an important risk factor for healthcare-associated infections.
The relationship between blood glucose levels and the risk of infections is an area of study for Giampaolo Greco, PhD, MPH, assistant professor of health evidence and policy at Mount Sinai Hospital, New York City. Greco’s work looks at a confluence of factors that may ultimately affect patient susceptibility to hospital-borne infections.
“First, as we know, diabetes is on the rise,” says Greco. “Second, people who undergo some type of stress, a surgery for example, develop temporary hyperglycemia (stress-hyperglycemia). This phenomenon occurs not only in patients with diabetes, but also in patients without diabetes.” Patients experiencing stress-hyperglycemia could be detected by testing their HbA1c level, which is considered an indicator of diabetes when the level is higher than 6.5 mg/dL, says Greco.
Another factor of importance is the modality used to capture glucose measurements during a patient’s hospitalization. Variations in the devices used and different approaches to measurement may lead to different clinical decisions, says Greco. “Glucose testing and management is an area where clinical labs could play an important role in preventing HAIs.”
Apart from his research on glucose and infections, Greco notes that resistance to multiple antibiotics has also become a central issue. However, an assay to rapidly determine the molecular targets of new compounds has recently been developed, and Greco believes that such an innovation could make a difference by helping to identify compounds active against multiple drug-resistant organisms.1
1. Nonejuie P, Burkart M, Pogliano K, Pogliano J. Bacterial cytological profiling rapidly identifies the cellular pathways targeted by antibacterial molecules. Proc Natl Acad Sci USA. 2013;110(40):16169–16174; published ahead of print 17 September 2013; doi: 10.1073/pnas.1311066110.