Bacteriuria Among Type 2 Diabetes Mellitus Patients Attending Ejisu Government Hospital in the Ashanti Region, Ghana

Abstract

Type 2 diabetes mellitus (T2DM) patients are at increased risk of infections, such as malignant otitis externa and rhinocerebral mucormycosis, with the urinary tract being the most affected (for example, emphysematous pyelonephritis commonly caused by Escherichia coli). Hence, this study assessed the prevalence of bacteriuria and antibiogram patterns of bacteria isolates among T2DM patients visiting the Ejisu Government Hospital in the Ashanti Region, Ghana. In this cross-sectional study, 58 patients visiting the hospital for routine healthcare were conveniently recruited after obtaining informed consent. Data on sociodemographic characteristics and medical history were obtained using pretested structured questionnaires. Mid-stream urine was collected for bacteria isolation and identification using standard bacterial culture and biochemical tests. Bacteria cultures ≥ 105 CFU/mL were considered significant bacteriuria. The antibiotic sensitivity patterns of the bacteria isolates were evaluated using the Kirby-Bauer disc diffusion method. Bacteriuria was recorded among 15.5% (9/58) of the patients, mainly those with no previous history (77.8%) and no symptoms (55.6%) of urinary tract infections (UTIs). E. coli (55.6%) and Klebsiella spp. (44.6%) were primarily isolated from the T2DM patients. All the bacteria isolates (E. coli and Klebsiella spp.) demonstrated the highest resistance to co-trimoxazole and tetracycline (55.6%) and a complete susceptibility to amikacin and levofloxacin (100%). However, 60% of the E. coli isolates and 25% of the Klebsiella isolates were multidrug resistant (MDR; resistant to at least one antibiotic agent in three or more antimicrobial categories). The study shows that T2DM patients have bacteria in their urine which are resistant to most common antibiotics, even among those with no history of UTIs; hence, routine bacterial culture and antibiotic sensitivity testing among T2DM patients is recommended for better patient management to reduce the co-morbidities of UTIs.