A prospective study of clinical presentation, need for hospitalisation, microbiology and outcome of urinary tract infections in diabetes mellitus

Abstract

Background: Diabetics are more prone to infections than their non diabetic counterparts. The urinary tract is the most common site of infection in diabetes mellitus patients. Urinary tract infections (UTIs) most of the time in diabetic patients are relatively asymptomatic, which can lead to renal failure and severe kidney damage. A combination of local risk factors and host factors in diabetes mellitus lead to bacteriuria commonly compared to non diabetics. Objective: To evaluate clinical presentation, need for hospitalisation, microbiology and outcome of UTI in diabetes mellitus. Methods: This prospective, descriptive study was conducted at Kerala Institute of Medical Sciences, a tertiary level multispecialty hospital in South India to study the clinical profile of UTI (clinical presentation, need for hospitalisation, microbiological profile and outcome) in Diabetes mellitus; also to find out reasons for hospitalisation and for UTI in Diabetes mellitus. Results: Among study population, 24% patients were in age group of 30 to 50 years, 52% patients were in age group of 51 to 70 year, 13% were in 71 to 80 year group. 32% (32patients) had growth of E. coli in urine, 14% (14 patients) had growth of k. pneumonia, 10%(10 patients) had growth of proteus, 9% (9 patients) had growth of S. aureus, 5%(5 patients) had growth of C. perfringens, 5% (5 patients) had growth of candida, 4% (4 patients) had growth of pseudomonas and Enterococcus. 52% (52 patients) had sepsis as the reason for hospitalization, 32% (32 patients) had fever as the reason, and 14% (14 patients) had flank pain as the reason and 1 patient each had pelvic pain and vomiting as the reason for hospitalisation. 18% (18 patients) had renal dysfunction and 32% (32 patients) had proteinuria. Conclusion: UTI requiring hospitalization in Diabetes mellitus was more common after 50 years of age and equal in men and women. Diabetics are at risk of an increased susceptibility to infections of the urinary tract and occur with increased frequency and severity, and complications are more common.