Clinical and bacteriological influence of diabetes mellitus on deep neck infection: Systematic review and meta-analysis.
BACKGROUND
Diabetes mellitus has been recognized as the most common systemic disease associated with deep neck infection. We report the first systematic review and meta-analysis of the influence of diabetes on clinical and bacteriological characteristics of deep neck infection.


METHODS
Articles were retrieved from PubMed, EMBASE, and the Japan Medical Abstracts Society database. A critical review of 227 studies identified 20 studies eligible for quantitative synthesis.


RESULTS
Diabetes was associated with higher prevalences of multispace spread of infection, complications, and failure to identify pathogenesis, with risk ratios (RRs) of 1.96, 2.42, and 1.29, respectively. Bacteriologically, patients with diabetes showed a higher prevalence of culture identification of Klebsiella pneumoniae (RR, 3.28), and lower prevalences of Streptococcus spp. (RR, 0.57) and anaerobes (RR, 0.54).


CONCLUSIONS
Deep neck infection with diabetes differs from that without in several clinical aspects. Again, bacteriological differences imply that diabetic infections might be populated by different bacterial flora.
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hiroshi
H
Hidaka
Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan.
Takuhiro
T
Yamaguchi
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Jun
J
Hasegawa
Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hisakazu
H
Yano
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.|Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Risako
R
Kakuta
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.|Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Daiki
D
Ozawa
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kazuhiro
K
Nomura
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yukio
Y
Katori
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology / Q000503:physiopathology*; D048909:Diabetes Complications / Q000382:microbiology / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000382:microbiology / Q000503:physiopathology*; D055815:Young Adult
complications; deep neck infections; diabetes mellitus; meta-analysis; systematic review