Urinary tract infection in diabetes: Susceptible organisms and antibiogram patterns in an outpatient clinic of a tertiary health care center

Abstract

We aimed to determine the influence of diabetes mellitus (DM) on uropathogens and antibiotic resistance pattern in urinary tract infection (UTI) in our center. Three hundred fifty-five DM patients and 165 non-DM patients with UTI were included in this retrospective study. Urine samples were processed in the laboratory following standard protocol. Mean age was higher in DM group (63.9 ± 12.4 vs 59.6 ± 17.3 years, respectively, P = 0.001). Females showed much higher UTI prevalence in both groups (85.6% in DM vs 70.3% in non-DM group, P = 0.000). Mean HbA1c level on admission was 9.3% (78 mmol/mol). Mean duration of DM was 13.9 ± 8.5 yr. E.coli was the predominant uropathogen for both (67.3% in DM and 61.8% in non-DM group). Most isolated microorganisms were sensitive to nitrofurantoin (87.0% in DM, vs 83.6% in non-DM group, P = 0.265). Mean DM duration of higher than 10,5 years showed greatest risk of multidrug resistance (MDR) (AUC = 0.58, sensitivity of 63.7% and specificity of 50%, P = 0.019). Diabetic patients with UTI had poor glycemic control and long-standing DM. Nitrofurantoin was the most appropriate antimicrobial agent for empirical use. The MDR was higher in patients with DM lasting longer than 10.5 years. [Med-Science 2019; 8(4.000): 881-6]

Keywords

• urinary tract infection
• diabetes mellitus
• antibiotic resistance