Assessment of urinary tract infection and their resistance to antibiotics in diabetic and non-diabetic patients (original) (raw)
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Urinary tract infection in type 2 diabetic patients: risk factors and antimicrobial pattern
International Journal of Research in Medical Sciences, 2015
Genito urinary tract infection is the commonest among infections affecting the diabetic patient. Diabetic patients are found to have an increase in the risk of urinary tract infection (UTI) by 60%. 1 UTI in diabetes involve the upper tract in 80%, are bilateral in most cases and are more prone for developing complications. 2 Changes in ABSTRACT Background: Diabetes increases the risk of infection and the commonest amongst them are the ones involving the genitourinary tract. Diabetic patients are found to have an increase in the risk of developing urinary tract infection (UTI) by 60%. The study aimed to determine the causative pathogens and their antimicrobial pattern, identify risk factors associated in type 2 diabetic subjects having UTI. Methods: This was an observational study conducted in the medicine unit of a tertiary care hospital over a period of 8 months. A total of 619 (M:F 289:330) type 2 diabetic subjects were studied. History, clinical examinations, and the duration of diabetes were recorded in all patients at admission. Diabetes was diagnosed based on the WHO criteria. An immunoturbidimetric method was used to estimate glycosylated hemoglobin (HbA1C%). Diagnosis of UTI was made from midstream urine samples of patients if the urine cultures has >10 3 to >10 5 colony forming units (CFUs)/mL of a pathogen. Results: Among the 619 diabetic patients 220 patients had pus cells in urine but 72 patients had insignificant colony count. 90 (60.8%) patients were more than 60 years old, 48 (32.4%) were in the age group of 40-60 years and 10 (6.7%) were less than 40 years old. Among the 148 patients studied 52 (35.1%) were males and 96 (64.9%) were females. 116 (78.4%) had diabetes for more than 15 years and the rest had a duration lesser than 15 years. The HbA1C of patients with and without UTI were 10.2 ± 1.6 and 8.4 ± 1.3 respectively. Gram negative bacilli were isolated from 129 (87.2%) patients which included E. coli in 75 (50.7%), Klebsiella in 30 (20.3%), Pseudomonas species in 12 (8.1%) and Citrobacter in 12 (8.1%). Gram positive cocci were responsible for UTI in 15(10.1%) of subjects including Enterococcus in 13 (8.9%) and Staphylococcus in 2 (1.3%). Gram negative bacilli including E. coli, the Klebsiella species, pseudomonas and Citrobacter had good response to piperacillin-tazobactum, cefoperazone sulbactum, imipenam and amikacin. Gram positive cocci (Enterococcus and Staphylococcus) responsible for UTI showed good susceptibility to vancomycin (81 and 94% respectively) but a high resistance to ciprofloxacin and tetracyclines (68 and 57% respectively). Conclusions: Female gender, age and duration of diabetes were found to have increased risk factors for developing UTI in diabetes. Escherichia coli was the commonest organism causing UTI in diabetes which showed good response to piperacillin/tazobactum, cefoperazone-sulbactum, imipenam and amikacin.
A Review on Clinical Manifestation and Treatment Regimens of UTI in Diabetic Patients
Iranian Journal of Medical Microbiology, 2022
The pervasiveness of urinary tract infections (UTIs) with their clinical manifestations in patients with diabetes mellitus has escalated amidst the past decade or so, as myriad predisposing factors contribute to its occurrence. Although the causative agent of UTI is Escherichia coli, the etiopathogenesis can be traced back to glycosuria in the renal parenchymal region. This has precipitated pyelonephritis and renal complications, including cytopathic and altered metabolism. Furthermore, impaired immunity with scarce IL-6, 8 in urine, urinary retention, and dysfunctional voiding raise susceptibility towards uropathogens, mainly E. coli. Treatment for UTI with diabetes is based on symptoms and severity, urologic abnormalities, renal function, bladder infections, and metabolic alteration. The treatment process or regimens for patients with type 2 diabetes with asymptomatic bacteriuria are very low or negligible. Adequate management with antibiotic regimens in symptomatic patients after critical diagnosis is crucial for prophylaxis and effective treatment.
REVIEW ABOUT DIABETES MELLITUS AND URINARY TRACT INFECTIONS
SOUTHERN BRAZILIAN JOURNAL OF CHEMISTRY, 2020
Diabetes mellitus (DM) is a clinical disease correlated with a deficiency of insulin secretion or action. It is one of the leading causes of morbidity and mortality worldwide. The global burden of diabetes is rising due to increasing obesity and population aging. Urinary tract infections (UTI) are common microbial infections known to affect the different parts of the urinary tract accounting for major antibacterial drug consumption. About 150 million UTI cases were diagnosed every year. Urinary tract infections are the most important and most common site of infections in a diabetic patient. Diabetic patients have been found to have a 5-fold frequency of acute pyelonephritis at autopsy than non-diabetics. Most of the urinary tract infections in patients with diabetes are relatively asymptomatic. The presence of this syndrome predisposes to much more severe infections, particularly in patients with acute ketoacidosis, poor diabetic control, diabetic complications such as neuropathy, vasculopathy, and nephropathy. The Gram-negative aerobic bacilli are the large group of bacterial pathogens that cause UTI with few species of Gram-positive bacteria. However, some fungi, parasites, and viruses have also been reported to invade the urinary tract. Urinary tract infection affects women more than men due to several factors such as proximity of the genital tract to the urethra, anatomy of the female urethra, sexual activity, menopause, and pregnancy. Other possible risk factors of UTI include allergy, obesity, diabetes, past history of UTI, contraceptive use, catheter use, and family history.
Clinical profile of urinary tract infections in diabetics and non-diabetics
The risk of urinary tract infection (UTI) is higher in diabetics compared to non-diabetics. The aetiology and the antibiotic resistance of uropathogens have been changing over the past years. Hence the study was undertaken to determine if there are differences in clinical and microbiological features of UTI between diabetic and non-diabetic subjects, to study the influence of diabetes mellitus on the uropathogens and antibiotic sensitivity pattern in patients with UTI. Method A total of 181 diabetics (83 males and 98 females) and 124 non-diabetic subjects (52 males and 72 females) with culture positive UTI were studied. Patients with negative urine culture (n= 64), those diagnosed and treated outside (n= 83) and not willing to participate in the study (n= 24) were excluded.
Study Of Diabetic Complication Of Urinary Tract Infection: A Review
International Journal of Pharmaceutical Sciences, 2024
Urinary tract infections are more common in the diabetic patients. Diabetic patients are severely affected with urinary tract infection. Treatment of UTI without proper diagnosis may lead to antimicrobial drug resistance. Treatment with antimicrobial agents should be started on the basis of culture reports. Only bacteriuria with symptoms of UTI should be treated with antibiotics to avoid the spread of drug resistant pathogens in the society. This practice can reduce the morbidity and mortality in diabetic patients suffering from urinary tract infection. The multidrug resistant pathogens are a challenge to society. Urinary tract infection may present as asymptomatic bacteriuria, acute uncomplicated urinary tract infection in women (acute cystitis or acute non obstructive pyelonephritis), complicated urinary tract infection in men or women with underlying abnormalities of the genitourinary tract and, in men, acute or chronic bacterial prostatitis. Infection is often recurrent, either as relapse when an organism persists within the genitourinary tract and recurs following treatment, or reinfection with new organisms introduced into the genitourinary tract.
Bacteriological finding of urinary tract infection in diabetic patients
Background: Diabetes mellitus has adverse effect on genitourinary system and patients suffering from diabetes mellitus are more prone to have urinary tract infection. Aims: To determine the prevalence of uropathogens in diabetic patient and to study their antibiotic susceptibility. Patients and Methods: urinary isolates and their patterns of susceptibility to the antimicrobials were evaluated in 60 diabetic patients with UTI (35 females-non pregnant and 25 males) from 122 diabetics attending National Center of diabetes Baghdad .Iraq. The specimens were examined for the various uropathogens using the standard microbiological procedures. Antibiotic susceptibility testing was performed for various antibiotics by Kirby Bauer disc diffusion method and the results were interpreted as per Clinical Laboratory and Standards Institute guidelines. The data was tabulated and analyzed. Results: The study showed that females are more vulnerable to pathogenic attack than males throughout a wide age distribution. Escherichia coli was the most common pathogen had been isolated followed by Staphylococcus aureus, Enterobacter species, Klebsiella pneumoniae and a few others. The isolates showed moderate to high level of sensitivity to various antibiotics tested. Conclusions: Diabetic patients are at a high risk of development of urinary tract infections. So continued surveillance of resistance rates among uropathogens is needed to ensure appropriate approach for the treatment of these infections.
Zanco Journal of Medical Sciences, 2013
Background and objective: Urinary tract infection (UTI) is a condition in which the urinary tract is infected with a pathogen causing inflammation. One of the predisposing factors for UTIs is diabetes mellitus (DM), spillage of glucose into the urine provide a good culture medium for bacteria. The objectives of this study were to evaluate the distribution of UTIs among diabetic patients of both genders with studying the effect of some relative factors, and identifying types of the causal microorganisms. Methods: Diabetic patients (type1 and 2), from both genders were included in this study. All patients were interviewed. Uncontaminated urine samples were collected for microscopic and macroscopic analysis. Isolations and identifications of bacteria were done by standard methods. Results: Out of 150 diabetic patients, 53 (35.33%) have UTI. Gender, middle age and high level of proteinuria were risk factors, while type and duration of DM with its type of treatment, body mass index (BMI), and hypertension were non significant. The isolated types of pathogens were Escherichia coli (45.3%), Klebsiella pneumoniae (15.1%), Staphylococcus saprophyticus (15.1%), Citrobacter diversus (11.3%), Candida albicans (7.5%) and Staphylococcus aureus (5.7%). Conclusion: This study revealed that diabetic females were most susceptible to get UTIs than diabetic males. In both genders the most reliable age for UTI were between 31-40 years. The results showed that the level of proteinuria was higher in patients suffering from UTIs associated with DM, which considered as a risk factor. Certain types of microorganisms were isolated; the most common types were Escherichia coli, Klebsiella pneumoniae and Staphylococcus saprophyticus.
Turkish Bulletin of Hygiene and Experimental Biology, 2018
Amaç: Çalışmamızda; tip 2 diabetes mellitusu (DM) olan ve bozulmuş glikoz toleransı (BGT) olan iki kadın hasta grubunun üriner sistem infeksiyonu (ÜSİ) ve asemptomatik bakteriüri (ASB) varlığı ve ilişkili risk faktörleri açısından karşılaştırılması amaçlandı. Risk faktörleri olarak; yaş, vücut kitle indeksi (VKİ), serum HbA1c ve kreatinin seviyeleri, glomerüler filtrasyon oranı (GFR), idrardaki lökosit sayısı, glikoz miktarı ve mikroalbumin düzeyi seçildi. Yöntem: Diyabetli 208 kadın hasta ve BGT'si olan 208 kadın hasta çalışmaya dahil edildi. Serum HbA1c ve kreatinin seviyeleri ve idrardaki lökosit sayısı, glikoz miktarı ve mikroalbumin düzeyi biyokimya laboratuvarında ölçüldü. GFR, Cockcroft-Gault formula kullanılarak hesaplandı. Hastalardan alınan orta akım idrarı mikrobiyoloji laboratuvarında kanlı agar ve EMB agara ekildi. Bulgular: Diyabetli hasta grubunda beş (%2) hastada, BGT hasta grubunda 15 (%7) hastada ASB saptandı. ÜSİ; diyabetik grupta dokuz (%4) hastada , BGT hasta grubunda yedi (%3) hastada belirlendi (p>0.05). Piyüri; her iki hasta grubunda ASB ile ilişkili risk faktörü idi ABSTRACT Objective: We aimed to compare a type 2 diabetic women groups with a women group with impaired glucose tolerance (IGT) for the presence of urinary tract infection (UTI) and/or asymptomatic bacteriuria (ASB) and related risk factors [age, body mass index (BMI), serum HbA1c and creatinine levels, glomerular filtration rate (GFR), and urine microalbumin, urine leukocyte and glucose levels] associated therewith. Methods: The study population consisted of 416 female patients and divided into two groups as the type 2 diabetes mellitus (DM, n=208) and the IGT (n=208) group. Serum HbA1c and creatinine levels and leukocyte counts, glucose level and microalbumin level in the urine, were measured in the biochemistry laboratory. GFR was calculated using the Cockcroft-Gault formula. Urine samples were inoculated on blood agar and Eosin-Methylene Blue agar medium and incubated for 24-48 hour at 37°C. Results: ASB was determined in 5 patients (2%) in the DM group and in 15 patients (7%) in the IGT group. UTI was detected in 9 patients (4%) in the diabetic group and in 7 patients (3%) in the IGT group (p>0.05).
Molecular Level Microbiological and Clinical Profile of Urinary Tract Infection in Diabetes Mellitus
Acta Scientific Medical Sciences, 2021
Introduction: The (UTI)-Urinary Tract Infection was most prevalent common disease that involves in all humans. The diabetes mellitus patients having greater chances to sickness while comparison to the non-diabetic patients. In the current research work, different parameters of microbiology in UTI having patients suffering from type 2 diabetes mellitus have been studied. Method: Total 1000 diabetes type1 and type 2 patients with age > 18 years with or without symptoms of UTI with significant bacteriuria were enrolled in the study. Identification of the UTI that was according to the clinical history, symptoms and detailed clinical examination and confirmed by urine examination. Other investigations (CBC, serum creatinine, blood urea, HBA1C, fasting and post meal blood sugar and USG abdomen with pelvis) were also done. In the patient's samples of the urine culture, patterns of antibiotic sensitivity have been observed. Results: The highest numbers of patients were of fever 105 (46.67%) followed by asymptomatic UTI [98; 43.56%]. The presence of anemia and leucocytosis had statistically no significant association with UTI while poor glycaemic control has statistically significant association with UTI in diabetic patients. E. coli (32.14%) was commonest microorganism isolated in urine culture. Gram negative organisms were mostly sensitive to-Imipenem, Piperacillin-tazobactam and Nitrofurantoin while gram positive bacteria were mostly sensitive to-Linezolid, Nitrofurantoin, Vancomycin, Tetracycline, Clindamycin and Azithromycin and showed increased resistance to Fluroquinolones and Cotrimoxazole. Candida sp. was sensitive to Fluconazole, Itraconazole. Conclusions: E. coli is the Universal common bacterial isolate. To treat the UTI with diabetes or without diabetes, aminoglycoside or nitrofurantoin have been used previously from long time. For treatment and prevention of UTI among patients there must be check of antimicrobial sensitivity and its resistance pattern.