Microbial Bioactives
Microbial Bioactives | Online ISSN 2209-2161
380
Citations
269.4k
Views
186
Articles
Volume 9 Number 1 2026
RESEARCH ARTICLE (Open Access)
Blood Glucose, Urea, and Creatinine Levels in Acute and Chronic Bacterial Pneumonia: A Comparative Bacteriological and Biochemical Analysis
Nahla Ghazi Mohammed Al Loza Razzaq1, 2*
Microbial Bioactives 9 (1) 1-8 https://doi.org/10.25163/microbbioacts.9110778
Submitted: 31 March 2026 Revised: 08 June 2026 Accepted: 15 June 2026 Published: 16 June 2026
Abstract
Community-acquired pneumonia remains a major cause of morbidity in adults, yet how its acute and chronic forms differ, both in the bacteria responsible and in the metabolic strain placed on the body, is still not entirely settled. This study compared bacteriological and biochemical profiles, focusing on fasting glucose, urea, and creatinine, across 80 adult patients with acute (n = 40) or chronic (n = 40) bacterial pneumonia and 40 matched healthy controls recruited at Merjan Teaching Hospital and affiliated clinics in Babylon Province, Iraq. Sputum cultures and standardized biochemical assays were performed for each participant, with group differences assessed using Kruskal-Wallis, chi-square, and Pearson correlation analyses, given that several variables departed from a normal distribution. Gram-positive cocci accounted for 90% of all isolates, with Streptococcus pneumoniae the most common organism overall (60%); Gram-negative bacilli were comparatively rare. Acute pneumonia clustered most heavily among patients aged 58 to 67 years, and smoking showed a striking association with both disease groups (chi-square = 56.12, p < .001). Fasting glucose and urea both differed significantly across groups (H = 7.59, p = .023; H = 17.17, p < .001, respectively), with urea rising most sharply among acute cases. These findings point toward bacterial pneumonia carrying a measurable metabolic signature, one that appears to track more closely with disease severity and smoking exposure than with chronicity alone, though the cross-sectional design cannot fully disentangle which factor is driving which. Larger, multicenter studies with adjusted models are warranted.
Keywords: Bacterial pneumonia; Fasting blood glucose; Serum urea; Serum creatinine; Smoking
References
Bae, S. J., Lee, S. H., Yun, S. J., & Kim, K. (2021). Comparison of IVC diameter ratio, BUN/creatinine ratio and BUN/albumin ratio for risk prediction in emergency department patients. American Journal of Emergency Medicine, 47, 198-204. https://doi.org/10.1016/j.ajem.2021.03.081
Bagshaw, S. M., Laupland, K. B., Doig, C. J., Mortis, G., Fick, G. H., & Mucenski, M. (2007). Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: A population-based study. Critical Care, 9(6), R700-R709. https://doi.org/10.1186/cc3889
Baron, E., Peterson, L., & Finegold, S. (1995). Bailey and Scott's diagnostic microbiology (9th ed.). Mosby.
Beier, K., Eppanapally, S., Bazick, H. S., Chang, D., Mahadevappa, K., Gibbons, F. K., & Christopher, K. B. (2011). Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of "normal" creatinine. Critical Care Medicine, 39(2), 305-313. https://doi.org/10.1097/CCM.0b013e3181ffe22a
Chung, Y., & Morgan, L. (2015). Acute pneumonia: Who is at risk in your practice? MedicineToday, 16(8), 35-42.
Dickerson, A. S., Lee, J. S., Keshava, C., Hotchkiss, A., & Persad, A. S. (2018). Assessment of health effects of exogenous urea: Summary and key findings. Current Environmental Health Reports, 5, 205-212. https://doi.org/10.1007/s40572-018-0198-8
Ehrlich, S. F., Quesenberry, C. P., Jr., Van Den Eeden, S. K., Shan, J., & Ferrara, A. (2010). Patients diagnosed with diabetes are at increased risk for asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and acute pneumonia but not chronic pneumonia. Diabetes Care, 33(1), 55-60. https://doi.org/10.2337/dc09-0880
Forbes, B. A., Sahm, D. F., & Weissfeld, A. S. (2007). Bailey and Scott's diagnostic microbiology (12th ed.). Mosby Elsevier.
Goto, A., Yamaji, T., Sawada, N., Momozawa, Y., Kamatani, Y., Kubo, M., Shimazu, T., Inoue, M., Noda, M., Tsugane, S., & Iwasaki, M. (2020). Diabetes and cancer risk: A Mendelian randomization study. International Journal of Cancer, 146(3), 712-719. https://doi.org/10.1002/ijc.32310
Kellum, J. A., Romagnani, P., Ashuntantang, G., Ronco, C., Zarbock, A., & Anders, H. J. (2021). Acute kidney injury. Nature Reviews Disease Primers, 7, 52. https://doi.org/10.1038/s41572-021-00284-z
Levey, A. S., et al. (2009). A new equation to estimate glomerular filtration rate. Annals of Internal Medicine, 150(9), 604-612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006
Majdan, M., Slezak, L., & Zacharovsky, M. (2011). Urea as a prognostic factor in community-acquired acute pneumonia. European Journal of Internal Medicine, 22(6), e145-e149. https://doi.org/10.1016/j.ejim.2011.05.006
Makris, K., & Spanou, L. (2016). Acute kidney injury: Diagnostic approaches and controversies. The Clinical Biochemist Reviews, 37(4), 153-175.
Palmer, T. M., Lawlor, D. A., Harbord, R. M., Sheehan, N. A., Tobias, J. H., Timpson, N. J., Davey Smith, G., & Sterne, J. A. (2012). Using multiple genetic variants as instrumental variables for modifiable risk factors. Statistical Methods in Medical Research, 21(3), 223-242. https://doi.org/10.1177/0962280210394459
Pan, P., Binjie, H., Min, L., Lipei, F., Yanli, N., Junwen, Z., & Xianghua, S. (2014). A meta-analysis on diagnostic value of serum cystatin C and creatinine for the evaluation of glomerular filtration function in renal transplant patients. African Health Sciences, 14(4), 1025-1035.
Samet, J. M. (2004). The 2004 report on smoking and health: A call for action. Chest, 126(1), 317-321. https://doi.org/10.1378/chest.126.1.317
Stevens, L. A., Coresh, J., Greene, T., & Levey, A. S. (2006). Assessing kidney function: Measured and estimated glomerular filtration rate. New England Journal of Medicine, 354(23), 2473-2483. https://doi.org/10.1056/NEJMra054415
Tseng, C. H. (2014). Diabetes but not insulin increases the risk of chronic pneumonia: A Taiwanese population-based study. PLoS ONE, 9(7), e101553. https://doi.org/10.1371/journal.pone.0101553
Vandepitte, J., Verhaegen, J., Engbaek, K., Rohner, P., Piot, P., & Heuck, C. C. (2003). Basic laboratory procedures in clinical bacteriology (2nd ed.). World Health Organization.
Van Duin, D., & Shaw, A. C. (2022). Immunosenescence in pneumonia pathogenesis and protection in older adults. Clinical Microbiology Reviews, 35(3), e00017-21. https://doi.org/10.1128/CMR.00017-21
Van Niekerk, G., Engelbrecht, A. M., & du Toit, A. (2020). The immunology of acute and chronic systemic inflammation: A focus on the metabolic context. Frontiers in Immunology, 11, 598673. https://doi.org/10.3389/fimmu.2020.598673
Wang, H., Luo, L., & Li, H. (2022). Stress hyperglycemia in patients with community-acquired pneumonia. BMC Pulmonary Medicine, 22, 87. https://doi.org/10.1186/s12890-022-01881-3
Watkins, R. R., & Lemonovich, T. L. (2011). Diagnosis and management of community-acquired pneumonia in adults. American Family Physician, 83(11), 1299-1306.
World Health Organization. (2013). WHO report on the global tobacco epidemic 2013: Enforcing bans on tobacco advertising, promotion and sponsorship.
Zafar, M. Z. (2016). A case study: Acute pneumonia. Occupational Medicine & Health Affairs, 4(4).
Zhou, Y., Zhang, Y., Wang, L., Wang, J., & Zhang, J. (2016). The metabolic characteristics of patients with chronic pneumonia. Scientific Reports, 6, 29394. https://doi.org/10.1038/srep29394
Recommended articles
Lung Cancer in Bangladesh: Epidemiological Burden, Tobacco and Environmental Risk Determinants, Diagnostic Delay, and Survival Challenges — A Systematic Narrative Evidence Synthesis
Article metrics
View details
0
Downloads
0
Citations
21
Views
0
Save
Save
0
Citation
Citation
21
View
View
0
Share
Share