Title: Clinical and Bacteriological Profile of Urinary Tract Infection in Diabetes Mellitus Patients: An Evaluative Study
Authors: Dr Tushar P. Lanjewar, Dr Priya A. Warbhe
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.04
Abstract
Background: Diabetes Mellitus (DM) is a metabolic disease of modern civilization. It is associated with reduced life expectancy, significant morbidity due to specific diabetes related microvascular complications, increased risk of macrovascular complications and diminished quality of life. Urinary tract infection (UTI) is a common infection observed in diabetic patients. DM alters the genitourinary system where UTI can cause severe complications ranging from dysuria, organ damage and even death due to complicated UTI. Current study was carried out to evaluate UTI pathogens its association with clinical profile and susceptibility patterns to antimicrobials among diabetic patients.
Materials and Method: A one-year cross sectional, descriptive study was carried out in tertiary care hospital. Total 60 patients of DM with UTI were included based on inclusion criteria. Research tool consisted of questionnaire, clinical examination and investigations. Pus cells grading into categories were taken as dependent variables and clinical parameters (duration of DM, glycosylated hemoglobin levels, past episodes of UTI, past catheterization) as independent variables.
Results: Incidence of UTI in D.M. was mostly seen in women and above 50 years of age. Fever was the commonest symptom, UTI most common in patients with past history of diabetes of less than 10 years duration. Most common organism isolated in UTI was E. coli. Gram negative bacilli were sensitive to imipenem, gentamycin, nitrofurantoin, and Gram-positive cocci were sensitive to vancomycin, linezolid, tetracycline in most of the patients. Poor Glycemic control was significantly associated with more pus cells in urine.
Keywords: Diabetes Mellitus, Urinary tract infection, Bacteriology, Antimicrobial sensitivity.
References
- Ronald A. and Ludwing E. Urinary tract infections in adults with diabetes. Int J Antimicrob Agents. 2001;17: 287–292.
- Rakel R., Rakel D. Textbook of Family Medicine. 7th edition. Philadelphia: Saunders Elsevier; 2007
- Rhaj A., Grover A. , Aggarwal V. , Jain S. Textbook of Family Medicine. 1st edition. New Delhi: Pushpanjali Medical Publications Pvt. Ltd; 2005
- Nicolle L. Asymtomatic bacteriuria in Diabetic women. Diabetes Care. June 2000; Vol. 23: No. 6: 23-25.
- Abramson J. et al. Survey methods in community medicine. 5th edition. USA: Churchill Livingstone publication; 1999.
- Action plan for the global strategy for the prevention and control of non-communicable diseases. Geneva: World Health organization; 2008.
- Hoepelman A., Meiland R. ,Geerlings S. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicrob Agents. 2003; S35-S43.
- Ananthnarayan and Panikar’s Textbook of Microbiology. 8th edition. Andrapradesh: University press; 2009.
- Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s principles of internal medicine. 17th ed. New York: McGraw Hill; 2008
- Janifer J., Geethalakshmi S.,Sathyavani K.,Viswanathan V. Prevalence of lower urinary tract infection in South India type 2 diabetic subjects. Indian. J Nephrol. 2009;Volume:19 Issue:3: Page:107-111.
- Gorter , Hakb E., Nicolas P, A Zuithoffa, Hoepelman A. and Rutten G. Risk of recurrent acute lower urinary tract infections and prescription pattern of antibiotics in women with and without diabetes in primary care. Family Practice. 2010; 27:379–385.
- Patterson J., Andriole V. Bacterial urinary tract infections in diabetes. Infect Dis Clin North Am. 1997;11(3):735–50.
- Corson C, Naber K. Role of fluroquinolones in the treatment of serious bacterial urinary tract infections. Drugs. 2004; 64 (12): 1359-73.
- Baqui R., Mubashir A., Ghulam R. Urinary tract infection in diabetic patients and biofilm formation of uropathogens. Infect Dis J. Jan- mar 2008; 17(1):7-9.
- Geerlings S. Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment. Int J Antimicrob Agents. 2008;31: S54–S57.