Clinical characteristics and risk factors of urinary tract infection in patients with gestational diabetes mellitus

Abstract

Objective To analyze the clinical features and risk factors of urinary tract infection in patients with gestational diabetes mellitus (GDM). Methods A total of 1 068 patients with GDM were enrolled from Nanshan People’s Hospital between January and December 2014. The incidence of urinary tract infection, pathogens distribution and drug resistance rate were retrospectively analyzed. Multivariate Logistic regression was performed to analyze the risk factors of urinary tract infection in GDM patients. Results Among 1 068 patients with GDM, 130 (12.17%) were compliacated with urinary tract infection One hundred of forty-two strains of pathogens were detected in the middle urine culture sample from urinary tract infection patients, Escherichia coli (67.61%, 96/142) and Klebsiella pneumonia (11.97%, 17/142) were the most frequent strains. Escherichia coli has high resistance to semi-synthetic penicillins, quinolones and sulfonamides, and relatively low resistance rate to carbapenems, aminoglycoside antibiotics and nitrofurantoin. Klebsiella pneumoniae was completely resistant to ampicillin, while was completely sensitive to carbapenems, aminoglycoside antibiotics, piperacillin/tazobactam, aztreonam. Logistic regression analysis showed that glycated hemoglobin >6.5% (OR=8.631, 95%CI 2.969-25.090, P 5.3 mmol/L(OR=3.116, 95%CI 2.040-4.761, P 2.6 mmol/L(OR=1.649, 95%CI 1.083-2.511, P 1.7 mmol/L(OR=2.986, 95%CI 1.256-7.112, P<0.05), history of urinary tract infection(OR=5.561, 95%CI 1.315-23.519, P<0.05) and history of maternity(OR=1.631, 95%CI 1.018-2.614, P<0.05) were the independent risk factors for urinary tract infection in GDM. Conclusion The incidence of urinary tract infection in patients with GDM is high. The control of blood glucose and blood lipids, enhanced health education for pregnant women with history of urinary tract infection and history of childbirth may reduce the occurrence of urinary tract infection in GDM patients. Key words: Diabetes, gestational; Urinary tract infection; Pathogenic bacteria; Risk factors