Asymptomatic and symptomatic bacteriuria in patients with type 2 diabetes

Abstract

Aim: Asymptomatic bacteriuria (ASB) and symptomatic bacteriuria with antibiotic-resistant organisms are common in patients with type 2 diabetes. The aim was to study the prevalence, bacterial profile and antibiotic susceptibility pattern in ASB and symptomatic bacteriuria and the factors associated with Escherichia coli bacteriuria in type 2 diabetes. Materials and Methods: This was an observational case-control study done on 400 asymptomatic type 2 diabetes patients, 200 symptomatic urinary tract infection (UTI), and 200 nondiabetic controls. Various clinical, biochemical parameters and urine examination and culture were studied. Results: The prevalence of ASB and symptomatic bacteriuria in type 2 diabetes was 17.5% and 69%, respectively, and were significantly higher as compared to controls (10%). E. coli was present in 52.9% of ASB cases of type 2 diabetes and 70% of nondiabetic control ASB. E. coli (55%) was most commonly isolated in symptomatic bacteriuria. Majority of the Gram-negative bacteria isolates in ASB and symptomatic bacteriuria with type 2 diabetes and controls were sensitive to amikacin, imipenem, piperacillin/tazobactam, and nitrofurantoin. E. coli were more resistant to quinolones in ASB and symptomatic bacteriuria than controls. Most of the Gram-positive bacteria were sensitive to vancomycin, linezolid, and amoxiclav. The factors associated with E. coli bacteriuria in type 2 diabetes were female gender, long duration of diabetes, past history of symptomatic UTI, poor glycemic control, and renal function. Conclusions: E. coli remains the most common isolated microorganism in asymptomatic and symptomatic bacteriuria. E. coli were more resistant to quinolones in patients with type 2 diabetes.