A comparative study of resistance to multiple antibiotics in urinary tract infection among diabetic versus non-diabetic patients in a tertiary care hospital

Abstract

Background: Tract infection (UTI) is a prevalent disease encountered in clinical practice, with increased prevalence in diabetic patients across all age groups. Left untreated, UTIs can lead to significant morbidity. Antibiotic resistance poses a significant challenge to managing this infection. This study aims to determine and compare the resistance patterns to multiple antibiotics used in treating UTI between diabetic and non-diabetic patients, addressing the existing gap in available data. Aims and Objectives: The primary objective of the study was to compare the resistance patterns to multiple antibiotics used in UTIs among diabetic and non-diabetic patients. The secondary objective was to assess the most common organism causing UTI. Materials and Methods: An observational study at K R Hospital of Mysore Medical College included 120 UTI-diagnosed patients. Diabetes history was confirmed through blood reports, and urine cultures were analyzed to identify UTI-causing organisms and assess sensitivity patterns. Results: The most common organism causing UTIs was found to be Escherichia coli in both groups (50% in diabetics, 43.33% in non-diabetics). Following this, in diabetics, Acinetobacter accounted for 18.33% and Klebsiella for 15%, while in non-diabetics, Acinetobacter was present in 15% and Pseudomonas in 12%. Imipenem showed the highest sensitivity (46.66% in diabetics, 43.33% in non-diabetics). Subsequently, nitrofurantoin and cotrimoxazole each displayed a sensitivity of 20% in diabetics. In nondiabetics, norfloxacin (31.66%), amikacin (20%), and gentamicin (20%) exhibited sensitivity. There was notably high resistance to ciprofloxacin (98.33% in diabetics, 78.33% in non-diabetics), followed by resistance to norfloxacin (91.66%) and ampicillin (66.66%) in diabetics, and 55% resistance to both nitrofurantoin and norfloxacin in non-diabetics. Diabetic patients showed a statistically significant reduction in susceptibility, particularly to norfloxacin, ciprofloxacin, gentamicin, cefotaxime, and ampicillin. In the study group, 100% of diabetic patients and 81.66% of non-diabetic patients exhibited resistance to three or more antimicrobial agents. Conclusion: Diabetic patients showed a significant decrease in sensitivity to fluoroquinolones, aminoglycosides, and beta-lactam drugs, highlighting the need for cautious use of higher antibiotics. Both groups exhibited an increased frequency of multidrug-resistant strains, emphasizing the importance of obtaining culture sensitivity reports prior to treatment initiation.