Urinary Tract Infection In Diabetic Patients Research Articles

Prevalence and Antibiotic Susceptibility of Urinary Tract Infections in Diabetic and Non Diabetic Individuals: A Prospective Study

Background & Objectives: Diabetes mellitus is increasingly recognized as a major health concern worldwide, particularly in developing countries like India. Diabetic individuals are known to have a higher susceptibility to urinary tract infections (UTIs), compounded by the emergence of drug-resistant uropathogens. This study aims to determine the prevalence and etiology of UTIs in diabetic patients. Materials and Methods: A cross-sectional prospective study involving 220 individuals was conducted from March to April 2023 to assess the spectrum of pathogens causing UTIs and their antibiotic susceptibility. Primary cultures were performed on McConkey agar and sheep blood agar, followed by identification and antimicrobial susceptibility testing (AST) using the Vitek2 system and Kirby Bauer's disc diffusion method on Mueller-Hinton agar. Results: Of the 220 samples tested, 150 exhibited significant bacteriuria, with 36 (75%) of 48 diabetic individuals testing positive for UTIs. Gram-negative bacilli (GNB) accounted for 135 (61.4%) isolates, with Escherichia coli (E. coli) being the most prevalent pathogen (52.7%), followed by Klebsiella spp. (25.3%). Among gram-positive organisms, Enterococcus spp. (5.3%) were predominant, with Candida isolates detected in 3 cases (2%). Meropenem (87.6%) exhibited the highest susceptibility against GNB, followed by Netilmycin (87.6%) and Imipenem (82.5%). For gram-positive organisms, Imipenem and Nitrofurantoin demonstrated high susceptibility. Conclusion: E. coli emerged as the predominant pathogen in both diabetic and non-diabetic populations. High sensitivity to meropenem, imipenem, amikacin, and fosfomycin was observed in both groups, suggesting their potential for empirical treatment. Regular surveillance of drug resistance patterns is crucial for identifying evolving resistance trends and optimizing treatment strategies.

Prevalence and Associated Factors of Urinary Tract Infections among Diabetic Patients: A Study at Kiryandongo Hospital, Uganda

Urinary tract infections (UTIs) pose a significant health concern, especially among individuals with diabetes mellitus. This study aimed to evaluate the prevalence and associated factors of UTIs among diabetic patients attending Kiryandongo Hospital in Uganda. A descriptive cross-sectional study design was employed, and data were collected using structured questionnaires. A total of 86 diabetic patients participated, with the majority being aged ≥50 years, married, and residing in rural areas. The prevalence of UTI among the studied patients was 14.0%. Age, sex, area of residence, duration of diabetes, history of UTI, and history of catheterization were identified as significant predictors of UTI. Females, older individuals, those with a longer duration of diabetes, and a history of UTI or catheterization were at higher risk of UTIs. These findings underscore the importance of screening and early treatment of UTIs in diabetic patients to mitigate associated complications andimprove health outcomes. Public health interventions aimed at UTI prevention and management should be prioritized among diabetic populations. Keywords: Urinary Tract Infections; Diabetes Mellitus; Prevalence; Associated Factors; Uganda Keywords: Urinary Tract Infections; Diabetes Mellitus; Patients, Glucose

Prevalence of Bacteriuria, and Characterization of Their Antimicrobial Sensitivity Pattern and Efflux Pumps Activity in Diabetic and Non-diabetic Uti Patients

Rationale: Urinary tract infections (UTI) occur more frequently in patients with type 2 diabetes. In developing countries, impairments in the defense system, metabolic disorder during diabetes, and incomplete bladder emptying all contribute to the pathogenesis of UTI in diabetic patients. This comparative study is undertaken to reveal the prevalence of uropathogens and their antimicrobial resistance patterns, and to assess hematological biomarker in diabetic and non-diabetic UTI patients. Methods: The prevalence of uropathogens were tested in 40 diabetic and 40 non-diabetic UTI patients. The antimicrobial susceptibility pattern of bacterial isolates were assessed by the Kirby-Buer disc-diffusion method. Moreover, the bacterial load, Gram-staining, biochemical and serological assays were performed using appropriate methods. Results: The findings showed that diabetic patients are more likely to UTI compared to non-diabetic patients. In terms of uropathogenic prevalence, 61% Escherichia coli, 34% Klebsiella pneumoniae, 2% Staphylococcus aureus, 2% Pseudomonas aureginosa and 1% others. The antimicrobial resistance profile demonstrated that most of the bacterial isolates were resistant to amoxicillin, ampicillin, erythromycin and methicillin but susceptible to azithromycin, chloramphenicol and ciprofloxacin. Moreover, the drug efflux pumps activity and bacterial burden were significantly high among antimicrobial resistant bacterial isolates. Besides, the C-reactive protein, Erythrocyte sedimentation rate, glycosylated hemoglobin A1C, neutrophils and lymphocytes were significantly high in diabetic UTI patients. Conclusion: This study found E. coli was the most frequent bacteria isolates, and this observation is consistent others. Diabetic UTI patients are more vulnerable with high bacterial burden and systemic inflammation. Bioresearch Commu. 10(1): 1413-1419, 2024 (January)

Nitrofurantoin Susceptibility Profile on Bacterial Isolates from Urinary Tract Infection in Patients with Diabetes Mellitus

Background: Patients with diabetes mellitus have a higher risk of urinary tract infection (UTI) incidence than those without. One of the first-line therapy for UTI is nitrofurantoin. The emergence of drug-resistant UTIs is increasing both in community and healthcare setups. Purposes: Determine the nitrofurantoin susceptibility profile to bacteria causing UTI in diabetic patients. Method: A cross-sectional study was conducted at the Microscopic Laboratory, Faculty of Medicine, Universitas Tanjungpura, Pontianak, from February to November 2019. The antibiotic susceptibility testing was performed by the Kirby-Bauer disk diffusion method on 22 bacterial isolates. The samples were collected on a sterile urine pot, cultured on agar, and identified by biochemistry test, and bacterial isolates were stored at 2-8oC. The bacterial isolates were sub-cultured 24h before the susceptibility test. The susceptibility testing used a 300 µg nitrofurantoin disk. The diameter of zone inhibition was measured and classified based on Clinical and Laboratory Standard Institute guidelines. Result: The results showed that Escherichia coli was 41.67% susceptible (5/12), Shigella sp. was 100% intermediate (1/1), and Enterobacter aerogenes (3/3), Pseudomonas aeruginosa (1/1), Klebsiella sp (1/1) were 100% resistant. Conclusion: The majority of the causative bacteria for UTI in diabetic patients are resistant to nitrofurantoin, suggesting the use of nitrofurantoin should be reconsidered as an empirical antibiotic in Pontianak. Further study using a larger population should be conducted to describe a more extensive antibiotic susceptibility profile of diabetic patients with UTI in Pontianak.

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.

Antimicrobial susceptibility of Escherichia coli isolated from diabetic patients in Mogadishu, Somalia.

Urinary tract infections (UTIs) are a major concern for diabetic patients due to the impact of diabetes on the urinary tract and immune system. Escherichia coli is the most common pathogen causing UTIs in diabetic patients and is known for its resistance. This study aimed to assess the antimicrobial susceptibility of Escherichia coli strains isolated from diabetic patients in Mogadishu, Somalia. This descriptive cross-sectional study was conducted at Ummah Hospital in Mogadishu, Somalia, from November 2021 to April 2022. Clean catch mid-stream urine specimens were collected from each participant and uropathogens were identified using standard techniques. The samples were cultured on CLED agar and antibiotic susceptibility patterns were determined using the Kirby-Bauer disk diffusion method. Data analysis was performed using SPSS version 20. The overall prevalence of uropathogens among diabetic patients was 236/350 (67.5%) with Escherichia coli being the most common organism. According to multivariate logistic regression, the results showed that Female diabetic patients had a significantly higher likelihood of developing UTIs compared to males (AOR = 2.5, 95% CI: 1.357-4.522, p = 0.003). The duration of diabetes, history of previous UTIs, and previous antibiotic use were also significantly associated with UTIs. All isolates were found to be resistant to Cefotaxime (100%). In addition, high resistance rates were observed with ofloxacin (91%), ciprofloxacin (77.8%), amikacin (60.9%), ceftriaxone (58.3%), and cefepime (51.8%). The most sensitive antibiotics were colistin and imipenem (99.6 and 88.6%, respectively), followed by gentamycin (70%). This study found a high prevalence of uropathogens and increased multi-drug resistance. Continuous surveillance is needed to monitor uropathogen prevalence and resistance rates, guiding treatment recommendations, rational prescription programs, and policy decisions.

Similarities in Bacterial Uropathogens and Their Antimicrobial Susceptibility Profile in Diabetics and Their Non-Diabetic Caregivers at a National Diabetes Management and Research Centre, Accra-Ghana.

Diabetes mellitus has some damaging effects on the genitourinary system and has been found to have adverse effects on the host immune system, resulting in higher risk of infections including urinary tract infections (UTI). Incidences of UTI caused by bacteria have been increasingly reported globally and the abuse of antibiotics leading to evolving resistant strains of antibiotics is a public health challenge for the management of this condition. Information on the difference in types of bacterial agents causing UTI in diabetic patients and non-diabetic individuals, and their susceptibility profiles, will facilitate effective management among these groups of patients. Therefore, this study aimed at determining the difference in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility profiles in diabetic patients and non-diabetic individuals at a diabetes management center. This was a prospective cross-sectional study conducted amongst 100 diagnosed diabetic patients and 100 non-diabetic individuals. Urine sample was collected aseptically and analyzed microbiologically for the presence of urinary tract bacterial pathogens. Drug susceptibility testing was conducted on the isolates by the Kirby Bauer method to ascertain the antibiotic susceptibility patterns. Among the diabetic and non-diabetic individuals, urinary tract bacterial pathogens were observed in 28.0% and 26.0% of samples, respectively. The organisms were in the following proportions for diabetic and non-diabetic individuals, respectively: E. coli (14/28, 50% and 8/26, 30.7%), S. aureus (2/28, 7.1% and 4/26, 15.4%), K. pneumoniae (4/28, 14.3% and 8/26, 30.7%), K. ozoenae (2/28, 7.14% and 0/26, 0%), K. oxytoca (0/28, 0% and 4/26, 15.4%) and C. urealyticum (6/28, 21.4% and 2/26, 7.69%). The difference between the proportions of bacteria isolated was, however, not statistically significant (p-value = 0.894). Bacteria isolated from both diabetic and non-diabetic individuals were highly susceptible to most of the antibiotics tested, especially nitrofurantoin, cefuroxime, ceftriaxone, and cefotaxime. This study has shown that similarities exist in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility patterns amongst diabetic patients and non-diabetic individuals at a diabetes management center. These data will help in the management of UTI among these individuals.

A Study On Clinical Profile of Urinary Tract Infection in Diabetes Mellitus in a Tertiary Care Hospital

Background: Diabetic Patients are at high risk of developing various infections especially if the diabetes is uncontrolled. Urinary tract infections (UTI) are one of the common infections in diabetics. Knowledge about the clinical and microbiological profile of UTI in diabetic patients will not only aid in early diagnosis but also helps in early initiation of appropriate empirical antibiotic therapy ensuring early recovery. Material & Methods: Prospective hospital based observational study. The study was conducted in the In-patient department, Department of General medicine at KMCT Medical college, Manassery, Kozhikode, Kerala, India. This study was conducted in 170 Diabetic patients above 18 years of age with symptoms of UTI with significant pyuria who were admitted under department of General Medicine, KMCT medical college, Kerala, who satisfied the inclusion criteria and gave consent for study. study consisted a total of 170subjects. Simple Random sampling method. Results: Fever was the most common clinical presentation followed by dysuria. E. coli was the most commonly isolated organism followed by Klebsiella. Most of the organisms were sensitive to Amikacin. Antibiotic resistance and Pyelonephritis were higher in patients with poor glycaemic control. The most common ultrasonographic abnormality was prostatomegaly. Conclusion: Patients with poor glycaemic control are at high risk of resistant UTI and Pyelonephritis. Good glycaemic control with routine monitoring of HbA1C is mandatory in diabetic patients to prevent UTI and to avoid its complications. E. coli was the most common organism isolated followed by Klebsiella. Most of the organisms were sensitive to Amikacin. Hence, Amikacin can be recommended as empirical antibiotic forDiabetic patients who are admitted with UTI.

Clinical effectiveness of beta-lactams versus fluoroquinolones as empirical therapy in patients with diabetes mellitus hospitalized for urinary tract infections: A retrospective cohort study.

BackgroundDiabetic patients are at risk of severe urinary tract infections (UTIs). Due to the emerging resistance rates to fluoroquinolones and β-lactams, we aimed to evaluate the effectiveness of β-lactams versus fluoroquinolones as empirical therapy for diabetic patients hospitalized for UTIs.MethodsA retrospective cohort study was conducted in a medical center in Taiwan between 2016 and 2018. Patients with type 2 diabetes, aged ≥20 and hospitalized for UTIs were enrolled. Patients with UTI diagnosis within one year before the admission, co-infections at the admission, or ≥2 pathogens in the urine cultures were excluded. The primary outcome was empiric treatment failure.Results298 patients were followed for at least 30 days after the admission. Escherichia coli (61.07%) was the most common pathogen. The resistance rates of the pathogens to levofloxacin were 28.52% and 34.22% according to the historical Clinical and Laboratory Standards Institute (CLSI) breakpoints and the updated 2019 CLSI breakpoints, respectively. The resistance rates of ceftazidime and cefepime were 21.81% and 11.41%, respectively. Empirical β-lactams were associated with less treatment failure compared to fluoroquinolones (adjusted OR = 0.32, 95% CI = 0.17–0.60). Beta-lactams were associated with less treatment failure than fluoroquinolones when appropriatness was determined by the pre-2019 CLSI breakpoints but not the 2019 CLSI breakpoints.ConclusionsIn diabetic patients hospitalized for UTIs, β-lactams were associated with less empiric treatment failure compared to fluoroquinolones when the resistance rate to fluoroquinolone is higher than β-lactams. The updated 2019 CLSI breakpoint for fluoroquinolone was better than pre-2019 CLSI breakpoints to correlate with treatment outcomes for hospitalized UTIs in diabetic patients.

Evaluation and Quantification of Resistant Gene in Antibiotic Resistant ESBL Producing E. coli in UTI Samples with Diabetes Mellitus: A Molecular Study

In diabetic patients, urinary tract infections (UTIs) are more common and severe often caused by antibiotic resistance and carry worse consequences, due to high blood sugar level and frequent urination. High blood sugar provides favorable environment for the growth of pathogens and some other impairment in immune system, poor metabolic control and incomplete emptying bladder to enhance the risk of UTIs in the diabetic patients. Most of the UTIs are caused by multidrug resistant, Extended Spectrum β lactamase (ESBL) producing bacteria mostly, Escherichiacoli (E. coli). The prevalence of UTIs caused by ESBL producing Multidrug Resistant (MDR) bacteria is a major global public health concern. The aim of this study was to identify the pattern of multidrug resistance and quantification of resistance genes amongst the E. coli isolates which were obtained from UTI patients with diabetes. ESBL producing stains were found 36% by using amoxicillin/clavulanic acid as a β lactamase inhibitor. Out of these stains, following antibiotics resistance rates were achieved with ampicillin, amoxicillin, amikacin, cefotaxime, ceftazidime, chloramphenicol, ciprofloxacin, gentamicin, nitrofurantoin, norfloxacin, tetracycline and amoxicillin/clavulanic acid as 100%, and 0%, respectively. The ESBL encoding genes were characterized for CTX-M, TEM and SHV genes. CTX-M gene was found to have resistance in the E. coli isolates, some others genes as TEM and SHV respectively. These characterized genes were analyzed through PCR which is a rapid, sensitive and easy to interpret detection method. Among these isolates, CTX-M was significantly higher 85.4% in the ESBL positive strains (p < 0.05). TEM and SHV were found 12.8% and 6.5%, respectively. Early and proper diagnosis is necessary for the management of UTIs in diabetic patients in order to have an adequate treatment.

Frequency of Urinary Tract Infections in Type 2 Diabetic Patients Taking Dapagliflozin.

BackgroundUrinary tract infections (UTIs) are common in patients with diabetes. The use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) to achieve good glycemic control increases glucose levels in urine. This glycosuria further enhances the risk of UTIs. This study aimed to evaluate the frequency of UTIs in patients with type 2 diabetes receiving the SGLT2i dapagliflozin as an add-on therapy.MethodsWe conducted this cross-sectional study at the Endocrinology Department of Hayatabad Medical Complex in Peshawar from April 2020 to September 2020. A total of 400 patients with diabetes receiving either 5 mg or 10 mg of dapagliflozin as an add-on therapy for the treatment of type 2 diabetes were included in this study. We collected blood and urine samples from participants and measured glycosylated hemoglobin levels. Urine samples were cultured on cysteine lactose electrolyte deficient agar. We used IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, NY) to analyze our data.ResultsThe prevalence of UTIs in diabetic patients receiving 5 mg or 10 mg of dapagliflozin was 5.3%. Women were more affected (76.2%) than men (p < 0.05). UTIs were more prevalent in patients older than 50 years (85.7%) than in any other age group. The dose strength of dapagliflozin was not associated with UTIs (p > 0.05).ConclusionThis study examined UTIs in patients taking dapagliflozin for the treatment of type 2 diabetes. These infections were mild to moderate and were treated easily. None of these infections caused the patient to discontinue the treatment. Dapagliflozin is well-tolerated in patients with diabetes but should be used with appropriate caution and monitoring.

Incidence of Urinary Tract Infection among Diabetic Patients in Abakaliki Metropolis

The investigation of urinary tract infection (UTI) among diabetic patients 15-51 years and above was assessed using 100 mid-stream urine specimen with the objective of isolating and identifying different types of bacteria and their respective frequencies among diabetic patients attending diabetic clinic at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. A urine culture was performed combined with a full report of urine to establish the diagnosis. The result showed that the majority of bacteria in urinary tract infections were in 27-32 years of age group (71.4%) and lowest in 15-20 years age group (0%). The predominant bacteria isolates and their percentage occurrences include; Escherichia coli (39.13%), Klebsiella pneumonia (21.74%), Proteus (8.69%), Pseudomonas aeruginosa (8.69%), Streptococcus (8.69%), Staphylococcus aureus (6.52%), Enterococcus faecalis (4.25%). There was a high prevalence of the isolated organisms in female (47.7%) compared to males (36%). It follows that most predominant agent of UTI in diabetic patients in Abakaliki Metropolis is Escherichia coli followed by Klebsiella pneumonia.

Urinary pathogenic bacterial profile, antibiogram of isolates and associated risk factors among diabetic patients in Hawassa town, southern Ethiopia: a cross-sectional study

Urinary tract infection (UTI) is the commonest bacterial infectious disease in community practice with a high rate of morbidity and financial cost. It has been estimated that 150 million people were infected with UTI per annum worldwide which costing global economy more than 6 billion US dollar. In humans, urinary tract is the second commonest site after the respiratory tract, for bacterial infection. Two hundreds forty seven diabetic patients were investigated for UTI using 5 to 10ml midstream urine sample. A loop full urine sample was inoculated on cysteine lactose electrolyte deficient (CLED) agar, MacConkey agar and Blood agar plates. Antimicrobial susceptibility test was done using Clinical and Laboratory Standards Institute (CLSI) for all patients. Age, sex, resident, marital status and other factors were used as exposure factor of the cross sectional study. The aim of this study was to assess etiology, risk factors and drug sensitivity pattern of uropathogenic bacteria isolated from diabetic patients. The overall prevalence of significant bacteriuria was 26(10.5%). Significant bacteriuria was significantly associated with age and body mass index. The predominant bacteria isolate was E. coli 12(46.2%) followed by Coagulase negative staphylococcus 7(26.9%).Gram negative bacteria showed high rate of sensitivity (94.1%) to Nitrofurantoin and Norfloxacine. Gram positive bacteria showed 100% sensitive for Amoxacillin-Clavunic acid. Multidrug resistance to two or more drug was observed in 19(73.1%) of bacteria isolates. The overall prevalence of significant UTI in diabetic patients was 10.5%. The most frequently observed organisms were E. coli, CONs, K. pneumoniae, K. oxytoca and S. aureus. Sex, age, BMI, occupational status such as house wife was statistically significant. Gram negative bacteria isolates were the most common antibiotic resistant bacteria isolates from UTI patients.

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.

Urinary Tract Infection in Patients with Diabetes Mellitus

Background: urinary tract infections (UTI) are one of the most common types of bacterial infection in patients with diabetes mellitus (DM). There are certain aspects to diabetes that makes it a risk factor for getting urinary tract infection and additionally, diabetes may also predispose to certain complications. Methodology: in this paper we aim to carry out a systematic review on observational (nonrandomized) studies on PUBMED. Aim: to evaluate the prevalence, pathogenesis, diagnosis, management and complications of UTI in patients with DM. Conclusion: the proper management of UTI in diabetics is crucial, as prompt diagnosis and correct use of antibiotics is vital for treatment. Future research in this regard will hopefully decrease the burden of UTI in diabetic patients.

Assessment of urinary tract infection and their resistance to antibiotics in diabetic and non-diabetic patients

Diabetic patients are more susceptible to urinary tract infections (UTIs) than non-diabetic patients and due to the development of multidrug resistant uropathogenic strains, the choice of antibacterial agents is being limited. The study was undertaken to determine the influence of diabetes mellitus on the uropathogens and antibiotic sensitivity pattern among patients with UTIs. A cross-sectional study was conducted in which total of 400 patients were studied out of which 150 were diabetics and 250 were non-diabetics. Patients with negative urine culture (n = 240) were excluded from the study and 160 patients with positive culture of UTIs of which 80 were diabetics and 80 were non-diabetics, included in this study. Clinical data were obtained from individual study participant with informed written consent using pre-tested questionnaire. According to the clean-catch procedure, midstream urine samples were collected and cultured for the diagnosis and susceptibility of bacteriuria. Out of 160 uropathogenic isolates, &lt;em&gt;E. coli&lt;/em&gt; was found as a leading pathogen i.e. 46.25% followed by &lt;em&gt;Candida spp&lt;/em&gt;. 30.62%, &lt;em&gt;S. Faecalis&lt;/em&gt; 15.62%, &lt;em&gt;P. aeruginosa&lt;/em&gt; 3.13%, &lt;em&gt;Pneumococcus&lt;/em&gt;. 1.25%, MSSA 1.25%, MRSA 0.63%, &lt;em&gt;Proteus spp&lt;/em&gt;. 0.63% and &lt;em&gt;Vancomycin resistant enterococcus spp.&lt;/em&gt; 0.63%. The results indicated that prevalence of UTIs was significantly higher in diabetic patients than in non-diabetic subjects. &lt;em&gt;E. coli&lt;/em&gt; was found to be the most common isolate. It was observed that UTIs in diabetic patients was more in female diabetic patients than in male patients. Investigation of bacteriuria in diabetic patients for UTIs is an important tool for the treatment and prevention of renal complications.

The Impact of Demographic Factors and Blood Sugar Control on the Incidence of Urinary Tract Infections in Khorramabad in 2013.

Background:Diabetes is one of the most serious metabolic disorders to affect different organs in the body. Patients with diabetes are hence at risk of developing other problems. Urinary tract infections (UTI) are one of the problems that occur more commonly in diabetic patients than in others. There are several risk factors that lead to the incidence of UTI in diabetic patients.Objectives:We conducted this study to determine the effect of different factors on the incidence of UTI in diabetic patients in order to decrease the incidence of this problem.Patients and Methods:In this cross-sectional study, data concerning 233 patients who were referred to the largest diabetes center in Khorramabad, Lorestan province, Iran, were recorded. The relationships between various factors and the incidence of UTI in these patients were evaluated using SPSS version 16. We used chi-square and logistic regression to analyze the data. A P < 0.05 was considered to be statistically significant.Results:The incidence of UTI increased significantly with increasing age (P = 0.009). The incidence of UTI was higher among females than among males, and it was higher among unemployed people than among those in other occupations. The prevalence of UTI among patients who control their diabetes through diet and exercise was lower than that among those undergoing other types of treatment; however, no significant relationship was found between the different types of oral medication and the incidence of UTI. We did not find any relationship between the incidence of UTI in diabetic patients and other factors such as literacy, marital status, BMI, addiction, history of hospitalization, and level of HbA1c.Conclusions:We found that age, gender, occupation, and the type of medication used are all risk factors for the incidence of UTI in diabetic patients. Other factors such as literacy, marital status, addiction, and history of hospitalization did not have any significant association with the incidence of UTI in diabetic patients.

Healthcare-associated infections and the distribution of causative pathogens in patients with diabetes mellitus

Diabetes mellitus (DM) is one of the most common diseases worldwide, and is a significant risk factor for healthcare-associated infections (HAIs). Our aim in this study was to compare the distributions of HAIs and the causative pathogens between diabetic and non-diabetic patients. In this study, 716 HAIs in 465 diabetic patients and 761 HAIs in 465 non-diabetic patients were evaluated. HAIs in patients with DM were most frequently urinary tract infections (UTIs) [266 infections (37.2 %)], followed by blood stream infections (BSIs) [161 infections (22.5 %)], surgical site infections (SSIs) [127 infections (17.7 %)], pneumonia [107 infections (14.9 %)] and any other infections [161 infections (22.5 %)]. The rates of UTIs, BSIs, SSIs, pneumonia and any other infections were similar between diabetic and non-diabetic patients. In terms of the causative pathogens, Staphylococcus aureus more frequently caused SSIs and Candida spp more frequently caused UTIs in diabetic patients compared with non-diabetic patients. We found no differences in the distribution of HAIs between patients without and with DM. However, S. aureus and Candida spp were more common causative pathogens of SSIs and URTIs, respectively, in diabetic patients than in non-diabetic patients.

Emphysematous Cystitis During Treatment of Suspected Nonconvulsive Status Epilepticus in Type 2 Diabetic Patient

Emphysematous cystitis is a rare disorder and complication of urinary tract infection (UTI), characterized by spontaneous gas formation in the urinary bladder because of bacterial fermentation. We present a case of emphysematous cystitis during treatment of suspected nonconvulsive status epilepticus in a patient with Type 2 diabetes mellitus. The patient recovered satisfactorily after 27 days of hospitalization. Treatment of emphysematous cystitis consisted of adequate urinary drainage, empirical antibiotic therapy, and strict blood glucose control. Diabetic patients are susceptible to an increased incidence of UTI and its complications. An early and correct diagnosis of UTI in diabetic patients followed by adequate treatment will prevent the disease from developing into a serious or life-threatening condition, such as emphysematous cystitis, or progressing to septic shock.

Prevalence and risk factors of urinary tract infections in type 2 diabetic women

Background: Diabetic patients are more susceptible to urinary tract infections (UTI) than non-diabetics .This study was carried out to determine the prevalence and risk factors of urinary tract infections in type 2 diabetic women in Tehran. Methods: This cross sectional study was designed to examine 511 non-pregnant type 2 diabetic women using consecutive sampling during September and March 2007. Subjects were selected from attendance of an Endocrine and Metabolism Institute of Iran University of Medical Sciences. Subjects were allocated in two symptomatic and non- symptomatic groups. Participants with symptoms of UTI and one positive urine culture were put in symptomatic group and those without symptoms of UTI with two positive urine cultures were assigned as non-symptomatic group. Asymptomatic UTI group was defined by the presence of more than 105 colony-forming units(CFU) per milliliter of one or two microorganisms in a culture of clean-voided midstream urine. Different related risk factors for developing UTI were investigated. Results: It was indicated that prevalence of symptomatic urinary tract infection was 6.2% and prevalence of asymptomatic urinary tract infection was 1.8%. In this study, age was the only variable among risk factors for UTI that showed significant association with urinary tract infection in diabetic women (p=0.049) There was no correlation between UTI and other risk factors. Conclusion: This study showed that the prevalence of urinary tract infections in type 2 diabetic women was lower than the previous studies. Age is a risk factor for UTI in diabetic patients .