Tract Infection In Diabetic Patients Research Articles

Prevalence and Associated Factors of Urinary Tract Infections among Diabetes Mellitus Patients at KIU-TH from January to December 2022

Globally, an estimated 150 million individuals are affected by urinary tract infections (UTIs) every year, with a significant number of those affected being diabetics. The International Diabetes Federation (IDF) reported that in the year 2019, there were about 60 million cases of patients suffering from diabetes who developed UTIs. The study assessed the prevalence and associated factors of urinary tract infections among diabetic mellitus patients in the medical ward at KIUTH. The objectives were to find out the prevalence and the factors associated with urinary tract infections among diabetic patients in the medical ward of KIU-TH. The study was descriptive, and it involved 87 patient files selected by purposive sampling, in which a checklist was the main tool of data collection. The study showed that female gender was significantly associated with the occurrence of urinary tract infection in diabetic patients at OR 0.17 (0.05–4.29) and PV 0.01. The study also shows that having other disease comorbidities was significantly associated with the occurrence of UTI among diabetic patients at OR 0.58 (0.35-8.07) and PV 0.002. The study also shows that having late diabetic disease among diabetic patients was also significantly associated with the occurrence of UTI among diabetic patients at OR 0.69 (0.35-8.19) and PV 0.004. The study concluded that 48 (55.2%) of diabetic patients had had a urinary tract infection, and therefore the study recommends that diabetic patients should be health educated on the causes and control of UTI so as to prevent their occurrences. The study also recommends that the government increase service provisions like treatments to reduce the occurrence of opportunistic conditions in UTIs, and the patients should be encouraged to seek regular medical checkups so that they monitor disease progression. Keywords: Diabetics, UTIs, Patients, Diabetes mellitus.

Particularities of Urinary Tract Infections in Diabetic Patients: A Concise Review.

Diabetes mellitus is a chronic disease that, untreated or poorly controlled, can lead to serious complications, reducing life expectancy and quality. Diabetic patients are more likely to develop infections, including many common infections, but also pathognomonic ones such as emphysematous pyelonephritis, malignant otitis externa, mucormycosis and Fournier's gangrene. Considering the fact that diabetic patients experience more frequently urinary tract infections (UTIs) with a worse prognosis than non-diabetic people, we conducted a review study based on data in the literature, following the particularities of UTIs in this group of patients, the risk factors, the mechanisms involved and the challenges in their management. The findings highlight that UTI in diabetic patients have some particularities, including a more frequent evolution to bacteremia, increased hospitalizations, and elevated rates of recurrence and mortality than non-diabetic patients. The possible risk factors identified seem to be female gender, pregnancy, older age, UTI in the previous six months, poor glycemic control and duration of diabetes. The mechanisms involved are related to glucosuria and bladder dysfunction, factors related to bacterial strains and host response. The bacterial strains involved in UTIs in diabetic patients and their antibiotic susceptibility profile are, with some exceptions, similar to those in non-diabetic people; however, the antimicrobial agents should be carefully chosen and the duration of the treatment should be as those required for a complicated UTI. The data related to the risk of developing UTIs in patients treated with SGLT-2 inhibitors, a new class of oral hypoglycaemic agents with cardiovascular and renal benefits, are controversial; overall, it was evidenced that UTIs occurred at the initiation of the treatment, recurrent infection was uncommon and the majority of UTIs responded to treatment with standard antibiotics. Moreover, interruption or discontinuation of SGLT-2 inhibitor as a result of UTI was rare and SGLT-2 inhibitors did not increase the risk of severe infections such as urosepsis and pyelonephritis.

Determination of Bacteriological Profile of Antimicrobial Susceptibility Testing among Diabetic Patients with Urinary Tract Infections in Shendi, Sudan

Background: Urinary tract infection is a widespread microbial disease and 2nd most disease in women due to the anatomy of women type 2 diabetes is a high risk of infection of the urinary tract. Objective: To identify the agent that causes urinary tract infections in diabetic patients, select the best antibiotic, and assess the types of diabetes that are connected with urinary tract infections. Materials and Methods: From May to August 2018, a hospital-based cross- sectional study was carried out. According to the established methodology, urine samples were obtained for culture and identification. All isolates underwent an antimicrobial susceptibility test (AST) using the Kirby-Bauer disk diffusion method. The Statistical Package for the Social Science (SPSS) version 20 was used to import the data from Epi-data version 3.2.1. Results: The study's findings indicated that E. coli is the most prevalent bacterium, with a prevalence of approximately (30.2%). It is followed by K. pneumoniae (26.3%), and then by Staphylococcus aureus and Saprophiticus in percentage (15%). Gentamicin has a high rate of antibiotic sensitivity (approximately 36%), while Ceftazidime has a high rate of antibiotic resistance (about 35%). Around (52%) of people are resistant to Ceftriaxone and Cloxacillin. Conclusions: There was a high rate of UTI in diabetes patients. Female diabetics were more likely to experience UTIs than male diabetics.E. coli and K. pneumoniae species making up the majority of isolates. The isolated pathogens were highly susceptible to Gentamicin, Cloxacillin, and Ceftriaxone. These findings demonstrate the importance of glycemic management in diabetics for reducing UTIs, regardless of age or sex. By treating UTIs with the appropriate antimicrobial medications and monitoring the antimicrobial susceptibility patterns of isolated microorganisms, antibiotic-resistant urinary organisms can be managed.

Bacteriuria with Unusual Uropathogens in Diabetics in Thi-Qar Province

This study was designed to investigate the causative agents of recurrent urinary tract infection in diabetic patients in Thi-Qar Province . The study included 87 Iraqi participants of whom 46 diabetics and 41 non diabetics healthy control . Urine samples were collected from each participant and cultured on blood and MacConkey agars ,followed by macro and microscopic identification and biochemical tests. API 20E and Vitek 2 compact systems were used as a confirmatory tests . The findings showed ,of the total 87 participants 60(69%) gave a positive growth for urine culture. The results also showed thatT2DM patients were more susceptible to UTI with positive urine growth of 23/26 (88%) compared to T1DM patients who showed 14/20 (70%), and the majority of cases were female. Escherichia coli is the most common isolates accounting for the majority of cases 29 (48%), followed by Klebsiellapneumoniae9(15%) and Acinetobacter radioresistens 8(13.3%).It can be concluded that diabetic patients are more susceptible to UTI, especially T2DM. According to the present results, the immune disturbance due to diabetic patients is taking tall on T2DM patients even with asymptomatic bacteriuria.

Prevalence and antibiotic sensitivity of uropathogens isolated from type-ii diabetic patients having urinary tract infection (UTI): A retrospective study from a rural tertiary care hospital

Background: Patients with Diabetes Mellitus are more prone to Urinary tract infection (UTI) than non-diabetic patients. Diabetes Mellitus has certain negative effects on the genital system and increases the incidence of urinary tract infection in diabetic patients. Design: Record based retrospective study. Methods: Records of patients with type-II diabetes having symptoms of UTI were reviewed from August 2021 to January 2022. Result: Out of 210 diabetic patients, the UTI rate was higher in females 59% than male 41%. The most common agents for causing UTI were E.coli followed by Pseudomonas aeruginosa, Klebsiella spp., Candida albicans and Candida non-albicans, Enterococcus, S.aureus and other organisms. About 70.68% Gram-negative isolates were resistant against ampicillin, 75.17% resistant against gentamycin, and 48.16% resistant against amoxicillin-clavulanic acid. Gram-positive isolates were 83.33% resistant against penicillin and 83.33% resistant against ciprofloxacin. However, both gram-negative and gram-positive were susceptible to nitrofurantoin. The overall multidrug resistance was observed in 201 out of 210 (95.71%) bacterial and candiduria isolates, while 3.33% of the isolates were resistant to one only antibiotic. Conclusion: Most common etiological agent is E.coli with high drug resistance to ampicillin and susceptible to nitrofurantoin. Therefore, performing urine culture and regular monitoring of UTI is essential.

A0118 - Management aspects of urinary tract infection in diabetic patients: A national survey among different specialties

A0118 - Management aspects of urinary tract infection in diabetic patients: A national survey among different specialties

The occurrence of urinary tract infection and determinant factors among diabetic patients at Dessie Referral Hospital, South Wollo, Northeast Ethiopia

Introduction:Diabetic patients have a higher tendency of developing all infections, especially infections of the genitourinary tract. Urinary tract infections cause considerable disorders in diabetic patients, and if complicated, can cause renal failure. In Ethiopia, the magnitude of diabetes mellitus-associated urinary tract infections increased from 7.1% in 2005 to 33.9% in 2019. The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of risk factors. This study aimed to determine the magnitude and factors affecting the urinary tract infections among diabetic patients which enable professionals to prevent infections and manage them effectively.Methods:Hospital-based cross-sectional study was conducted with 365 diabetic patients selected by systematic sampling technique from March to April 2020. Data were collected by trained BSc nurses via face-to-face interview and patient chart review. Urine microscopy was done to diagnose urinary tract infections. Data were coded and entered using Epi data version 3.1 and exported to Statistical Package of Social Sciences version 26 for analysis. Variables with p-value < 0.25 in bivariable logistic regression were included multivariable logistic regression and variables with a p-value < 0.05 were considered statistically significant.Results:The magnitude of urinary tract infections was 22.3% (95% confidence interval: 18–27). The odds of being infected by urinary tract infections were significantly higher in diabetic females (adjusted odds ratio: 2.46; 95% confidence interval: 1.40–4.32), duration of diabetes mellitus diagnosis of ⩾5 years (adjusted odds ratio: 1.98; 95% confidence interval: 1.05–3.72), with comorbidity (adjusted odds ratio: 4.87; 95% confidence interval: 2.76–8.59) and khat chewer (adjusted odds ratio: 1.84; 95% confidence interval: 1.04–3.24) compared with their counter.Conclusion and recommendation:Urinary tract infections were high among diabetic patients. Predictors like sex, duration of diagnosis, comorbidity, and khat chewer were found to be associated with urinary tract infections. Improvement of the regular screening of patients with diabetes mellitus for urinary tract infections will provide more effective measures in prevention and management.

Myroides causing Catheter Associated Urinary Tract Infection in Diabetic Patients: An Emerging Multidrug Resistant “Superbug”

Myroidesis a nonfermentative, gram-negative rod shaped bacterium which is an emerging multidrug resistant pathogen causing many serious hospital acquired infections like Catheter Associated Urinary Tract Infection (CAUTI). The authors report a case series (four cases) of CAUTI caused by Myroides species which was resistant to all tested antibiotics (ticarcillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefepime, aztreonam, cefoperazonesulbactam, imipenem, meropenem, amikacin, gentamycin ciprofloxacin, levofloxacin, colistin, tigecycline) and sensitive only to minocycline (minimum inhibitory concentration &lt;1 μg/mL), in long-standing Diabetic Mellitus Type II patients. All the four patients were successfully treated with minocycline. Present cases highlight the importance of Myroides as a pathogen in Urinary Tract Infection (UTI) in diabetic patients, especially in nosocomial settings which clinicians should keep in mind.

Pervasiveness of urinary tract infection in diabetic patients and their causative organisms with antibiotic sensitivity pattern

Diabetes mellitus (DM) being polygenic disorder, affects several other organs. One of the major coinfection in DM is urinary tract infection (UTI). Due to increased blood glucose levels, a favorable environment is offered to bacteria for their growth leading to infection. DM also hampers immunologic functions such as phagocytosis, decrease in antibody production, failure of T cells and B cells to fight against pathogens which ameliorate bacterial growth. Not only bacteria but even several fungi can lead to UTI. Several factors such as duration of diabetes, age, gender, route of drug administration, type of drugs used in diabetes, poor glycemic control, obesity, unhygienic conditions, sexual intercourse, and type of DM are enhancing factors for causing UTI in diabetic patients. Day-to-day use of antibiotics has made several pathogenic bacteria resistant to the effects of antibiotics. In long terms, if UTI remains untreated in diabetic patients, then it may have severe complications. Furthermore, the resistance pattern of antibiotics differs according to the geographical locations. Hence, the use of susceptible antibiotics to cure UTI in diabetic patients is now crucial.

Genotypic and Phenotypic Diagnosis of Pseudomonas aeruginosa Associated with Urinary Tract Infection in Diabetic Patients and Their Resistance to Certain Antibiotics

Genotypic and Phenotypic Diagnosis of Pseudomonas aeruginosa Associated with Urinary Tract Infection in Diabetic Patients and Their Resistance to Certain Antibiotics

Does Secretor Status of ABO Blood Group in Saliva Influence the Risk of Hypertension and Urinary Tract Infection in Diabetic Patients?

Does Secretor Status of ABO Blood Group in Saliva Influence the Risk of Hypertension and Urinary Tract Infection in Diabetic Patients?

An overview of urinary tract infection in diabetic patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Host characteristics and virulence typing of Escherichia coli isolated from diabetic patients

IntroductionEscherichia coli is one of the most important bacteria that causes gastrointestinal and extra-intestinal infections (ExPEC) such as septicemia, cystitis, pyelonephritis, and meningitis in newborns. The aims of this study were to evaluate the association of host and bacterial factors in diabetic patients with E. coli infections. Materials and methodsForty-two E. coli isolates were collected from septicemia and urinary tract infection in diabetic patients in Iran. The antibiotic susceptibility testing was conducted by disk diffusion method using 15 antibiotics. Phylogenetic grouping was performed by PCR according to the chuA, yjaA and TspE4.C2 genes. Serogroup typing with using the 12 O-antigen were analyzed by PCR. Twelve virulence genes (cdt, TcpC, kpsMTII, iutA, cnf1, hlyA, traT, ibeA, csgA, vat, sat and pic) were identified by PCR. ResultsDiabetic patients had an age ranging from 24 to 83 years old. Resistance pattern was erythromycin (100%), amoxicillin (95.2%) and cefazolin (90.4%) and meropenem, imipenem, and phosphomycin were 100% susceptible. The B2 and D phylogroups are the most common strains were diabetic patients. 85.7% of E. coli causing septicemia in diabetic patients there have curli fimbriae. It was found that 38% of strains isolated from patients with diabetes possess antigens O1 and O75. So it can be concluded that traT and KpsMII with csgA genes are the main reasons of sepsis in patients with diabetes. ConclusionSerogroups O18, O25, and O75 belonged to B2 phylogroup and O1 and O2 were dominant in D phylogroup. The two phylogroup were present in 67% of the strains included in diabetics. E. coli carrying virulence factors csgA, KpsMII, iutA, and traT exhibited a high prevalence were causing septicemia in diabetic patients. The choice antibiotics prescribed for patients with diabetic suffering the septicemia were phosphomycin, imipenem, and meropenem.

Prevalence, Antimicrobial Susceptibility Pattern, and Associated Factors of Urinary Tract Infections among Adult Diabetic Patients at Metu Karl Heinz Referral Hospital, Southwest Ethiopia.

Urinary tract infection causes considerable morbidity in diabetic patients and if complicated, can cause severe renal damage and life-threatening infections. The escalating antimicrobial resistance rate among bacteria over the past years is another concern in the treatment of urinary tract infections. This study investigated the prevalence, antimicrobial susceptibility pattern of the isolates and associated factors of urinary tract infection among adult diabetic patients attending Metu Karl Heinz Referral Hospital, Southwest Ethiopia. An institutional-based cross-sectional study was conducted among 233 adult diabetic patients selected using simple random sampling technique. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence of pathogenic bacteria and their antimicrobial susceptibility pattern using recommended culture methods. Data were entered, cleaned, and analyzed using the Statistical Program for Social Sciences version 21.0. Statistical significance was set at a p-value < 0.05. The prevalence of urinary tract infection was 16.7% (95%, CI: 12.0, 21.5). The predominant isolates were Escherichia coli (25.6%) and Klebsiella spp. (20.5%). E. coli isolates showed higher sensitivity to ceftriaxone (80%), ciprofloxacin (70%), and gentamycin (70%), but resistant to tetracycline (60%). Staphylococcus aureus was sensitive to amoxicillin-clavulanic acid (85.7%), and gentamycin (57.1%), while resistant to tetracycline (85.7%), nitrofurantoin (85.7%), and ampicillin (71.4%). The odds of developing urinary tract infections were significantly higher in diabetic females (AOR: 3.56, 95% CI: 1.44, 8.76), those who were not able to read and write (AOR: 2.55, 95% CI: 1.19, 5.49) and those with a history of urinary tract infection (AOR: 2.31, 95% CI: 1.09, 4.90) compared with their counterparts. In this study, the prevalence of urinary tract infection among diabetic patients was relatively comparable with the previous studies conducted in Ethiopia. Management of urinary tract infection in diabetic patients should be supported with culture and antimicrobial susceptibility testing.

Uropathogens antibiotic resistance patterns among type 2 diabetic patients in Kisii Teaching and Referral Hospital, Kenya.

IntroductionNon-insulin dependent diabetes mellitus is a major risk factor for urinary tract infections. Irrational use of antibiotics has led to the emergency of uropathogens resistant to available antibiotics. The main objective was to determine the bacterial causative agents of urinary tract infections and their antibiotic resistance patterns.MethodsOne hundred and eighty (180) type 2 diabetic patients were recruited to take part in the study. Urine samples were collected and cultured for urinary tract infections diagnosis and antibiotic sensitivity.ResultsA total of 35 isolates were obtained from the study. All the isolates were sensitive to gentamicin. All 21 (100%) isolates of E. coli were sensitive to gentamicin and cephalexin. All 10 (100%) K. pneumoniaeisolates were sensitive to gentamicin and nitrofurantoin. Out of the 21 E. coli isolates, five of them showed resistance to ampicillin, three E. coli isolates showed resistance to nitrofurantoin and another three E. coliisolates showed resistance to co-trimoxazole. Out of 10 K. pneumoniae isolates, two of them were found to be resistant to ampicillin, one K. pneumoniae isolate was resistant to cephalexin and two K. pneumoniaeisolates were resistant to co-trimoxazole. Out of the four P. mirabilis isolates, there were three cases where one isolate was each resistant to ampicillin, nitrofurantoin and co-trimoxazole.ConclusionThere is a need to have a regular screening of bacterial isolates causing urinary tract infection in diabetic patients and their antibiotic sensitivity in order to have effective therapy. Present findings show that there is increased resistance to the commonly prescribed antibiotics.

Clinical and Laboratory Profile of Urinary Tract Infections in Type 2 Diabetics Aged over 60 Years.

Urinary tract infections are frequently encountered among diabetic patients and the incidence rate increases with age. There have been growing research to identify the clinical profile of urinary tract infections in diabetic patients. However, such studies on elderly patients are rare. To determine the risk factors, clinical/laboratory profiles, causative organisms and antimicrobial susceptibilities in type 2 diabetics aged over 60 years. This prospective single centre study was conducted at NRI Medical College and General Hospital, Guntur, India, between November 2012 and November 2014. A total of 100 consecutive patients with type 2 diabetes mellitus, aged over 60 years, with symptoms suggestive of urinary tract infection were examined. Subsequently, the demographic characteristics, detailed medical history, signs/symptoms of urinary tract infections, laboratory investigations for blood and urine samples, ultrasound abdomen findings were compared between bacteriuric and non bacteriuric patients. In addition, the organisms in urine cultures and antibiotic sensitivity patterns were investigated for bacteriuric patients. Two groups were compared using the Mann-Whitney test for continuous variables and the Chi-square or the Fisher's exact test for categorical respectively. Bacteriuria was found in 43% of type 2 diabetic patients aged over 60 years. Comparative analysis revealed that bacteriuria was more common among patients with female gender (p=0.028), diabetes duration of >15 years (p=0.011) and diabetes complications such as neuropathy (p=0.027) and diabetic foot (p=0.003). Age and uncontrolled fasting blood sugar or HbA1c levels did show an increased propensity for developing urinary tract infections. Increased frequency (76.7%), and urgency (67.4%), dysuria (65.1%) were significantly more common among bacteriuric patients than that in nonbacteriuric patients (p<0.05). Urine culture analysis revealed that E. coli (69.8%) was the most common causative organism, followed by Klebsiella (16.3%). Majority of isolated organisms were sensitive to antimicrobial agents like nitrofurantoin and imipenem. Bacteriuria was very common in elderly patients with diabetes. The observed trends in risk factors, clinical profile, laboratory profile, causative organism patterns, and antimicrobial susceptibilities will help to add the growing literature on this topic.

Prevalence of Bacteriuria and Antimicrobial Susceptibility Patterns among Diabetic and Nondiabetic Patients Attending at Debre Tabor Hospital, Northwest Ethiopia.

Background. Urinary tract infection is a major health problem especially in developing countries. Information about bacterial pathogens isolated from urinary tract infection in diabetic patients and their antimicrobial susceptibility patterns is limited in Ethiopia. Therefore, this study aimed at isolating bacterial pathogens and their antimicrobial susceptibility patterns. Methods. A hospital based comparative cross-sectional study was conducted at Debre Tabor. Urine sample was inoculated onto cysteine lysine electrolyte deficient (CLED) medium. Bacterial pathogens were identified using standard bacteriological methods. The data were cleaned and entered into SPSS version 20. P value less than 0.05 is considered statistically significant. Result. A total of 384 study participants were included in the study. Of them, 21 (10.9%) were from diabetics and 9 (4.7%) of them were from nondiabetics. Large proportion of gram positive bacteria at 18 (58.1%) were isolated compared to gram negatives at 13 (41.9%). Gram positive isolates were resistant to cotrimoxazole 10 (58.8%). Conclusion. The isolation rates of bacterial pathogens were higher in diabetic than nondiabetic patients. Bacteriuria was significantly associated with sex and type of diabetes. Multidrug resistance to two or more antibiotics was observed in 56.7% of bacterial isolates. Rational use of antimicrobial agent should be thought of to prevent the emergence of multidrug resistance.

Profile of urinary tract infection in diabetic patients. Data from a general hospital at Jammu and Kashmir, India

30Apr 2016 Profile of urinary tract infection in diabetic patients. Data from a general hospital at Jammu and Kashmir, India. Henna Naqash.

Assessment of nosocomial urinary tract infections in diabetic patients at a University Hospital in Turkey

Assessment of nosocomial urinary tract infections in diabetic patients at a University Hospital in Turkey

Emphysematous cystitis: The role of CT imaging and appropriate treatment

Emphysematous cystitis is a relatively rare disease characterized by the presence of gas in the bladder wall and/or lumen. The primary risk factor is diabetes mellitus. Emphysematous cystitis should be considered in cases of urinary tract infections in diabetic patients with unusual presentations. Imaging studies are necessary to detect emphysematous cystitis. Accurate diagnosis of the disease and appropriate treatment typically results in a favourable prognosis and can improve the outcome. We present a case of emphysematous cystitis diagnosed by a computed tomography scan in a diabetic woman with poor glycemic control.