Infections in Glucose-6-Phosphate Dehydrogenase G6PD-Deficient Patients; Predictors for Infection-Related Mortalities and Treatment Outcomes

Abstract

Disturbances in the count or maturity of blood cells weaken their microbial defensive capacity and render them more susceptible to infections. Glucose-6-phosphate deficient patients are affected by a genetic disease that affects cell integrity with increased liability to infections and death. We aimed to investigate the risk factors for infection mortality in this patient population. We retrospectively examined the records of G6PD adult patients with confirmed infections and collected data related to demographics, infections (pathogens, types, and treatment regimens) in addition to mortality and length of stay outcomes. Data were statistically analyzed using R Programming language to identify contributing factors to mortality and treatment regimens association with outcomes. Records of 202 unique patients over 5 years were included, corresponding to 379 microbiologically and clinically confirmed infections. Patients > 60 years [p = 0.001, OR: 5.6], number of comorbidities 4 (2–5) [p < 0.001, OR: 1.8], patients needed blood transfusion [p = 0.003, OR: 4.3]. Respiratory tract infections [p = 0.037, OR: 2.28], HAIs [p = 0.002, OR: 3.9], polymicrobial infections [p = 0.001, OR: 10.9], and concurrent infection Gram-negative [p < 0.001, OR: 7.1] were significant contributors to 28-day mortality. The history of exposure to many antimicrobial classes contributed significantly to deaths, including β-lactam/β-lactamase [p = 0.002, OR: 2.5], macrolides [p = 0.001, OR: 3.34], and β-lactams [p = 0.012, OR: 2.0]. G6PD patients are a unique population that is more vulnerable to infections. Prompt and appropriate antimicrobial therapy is warranted to combat infections. A strict application of stewardship principles (disinfection, shortening the length of stay, and controlling comorbid conditions) may be beneficial for this population. Finally, awareness of the special needs of this patient group may improve treatment outcomes.

The Association between Glucose 6-Phosphate Dehydrogenase Deficiency and Attention Deficit/Hyperactivity Disorder

“…This finding is in line with the association between ADHD and inflammatory somatic conditions [36][37][38], between ADHD and infectious diseases [25][26][27] and between G6PD deficiency and COVID-19 infection and immune-related diseases [39]. G6PD-deficient patients, similar to individuals with ADHD, exhibit a higher incidence of infectious diseases worldwide, indicating a vulnerability to infections [40,41]. Exposure to infectious conditions and certain foods or medicines among G6PD-deficient subjects affect RBCs, leading to hemolysis associated with neurological and psychiatric problems.…”

“…Studies have demonstrated that individuals with ADHD exhibited higher rates of infections including COVID-19 [25,26] with higher rates of severity [29,47] and complications [27]. Similarly, it was shown that G6PD-deficient individuals have a higher incidence of infectious diseases, indicating a predisposition to infections [40,41,45,46,48]. Our previous study showed that G6PD-deficient individuals had a higher risk of COVID-19 infection, of COVID-19 hospitalization, and of developing long-COVID [46].…”