Abstract

Diabetic patients in Nigeria are disproportionately affected by bacterial and fungal infections, with hyperglycemia, 
immune dysfunction, and comorbidities increasing susceptibility and complicating clinical outcomes. Common 
pathogens include Staphylococcus aureus, Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Candida 
spp., with rising rates of multidrug-resistant organisms such as MRSA, ESBL-producing Gram-negative bacteria, 
and azole-resistant fungi. These resistance patterns challenge empirical therapy, prolong hospital stays, increase 
morbidity and mortality, and escalate healthcare costs. Effective management requires a multifaceted approach 
incorporating accurate microbiological diagnosis, empiric therapy guided by local antibiograms, timely de
escalation, and non-antibiotic interventions including glycemic control, wound offloading, debridement, and 
vascular assessment. Early involvement of multidisciplinary teams, strengthened infection prevention and control 
measures, and implementation of context-specific antimicrobial stewardship programs are critical to reducing 
resistance and improving patient outcomes. Enhanced surveillance, research, and community education further 
support evidence-based policy and clinical decision-making to optimize infection management in diabetic 
populations.