Urinary tract infections in postmenopausal women with type 2 diabetes: clinical correlates and quinolone susceptibility.

Abstract

INTRODUCTION Diabetes mellitus and the postmenopausal period are associated with increased riskof urinary tract infections (UTIs) in women. However, data on UTIs in postmenopausal diabetic womenare scarce. OBJECTIVES The aim of this study was to determine the prevalence of UTIs in postmenopausal womenwith type 2 diabetes mellitus, identify the potential risk factors, describe the causative pathogens, and assess their susceptibility to quinolones. PATIENTS AND METHODS Patients were interviewed, examined, and had their hospital records analyzed.An uncontaminated midstream urine sample was collected and cultured in selective or enriched media.Colony‑forming units were counted and susceptibility to quinolones was assessed. Univariate and multivariate logistic regression models were built. RESULTS Forty women were included in this prospective cross‑sectional study; their median age was64 years (range, 52-84 years). UTIs occurred in 37.5% of the patients. The major implicated pathogenswere Escherichia coli (66.7%) and enterococci (20%; most often Enterococcus faecalis). Most ofthe pathogens (93.8%) were susceptible to all tested quinolones. Patients with UTIs had a significantlylower glomerular filtration rate (P = 0.008) and higher comorbidity index (P = 0.01) compared withpatients with sterile urine. Microangiopathic complications, including retinopathy and nephropathy, were identified as independent risk factor for UTIs (adjusted odds ratio, 3.5; 95% CI, 1.2-5.5; P = 0.006). The other clinical correlates of UTIs were urinary incontinence, hyperlipidemia, and microalbuminuria. CONCLUSIONS Postmenopausal diabetic patients with microangiopathy are at high risk of UTIs andtherefore should be educated and vigilantly monitored. Attention should also bepaid to urinary incontinence, hyperlipidemia, and microalbuminuria as other risk factors for UTIs. Quinolones are an attractive treatment option in this group of patients in Poland.