Clinical and laboratory profile of urinary tract infection in diabetic patients

Abstract

Background: Diabetic patients have higher risk of urinary tract infection (UTI).The present study was undertaken to study clinical and laboratory profile of UTI in diabetics and also study yield of urine culture in UTI, common causative organisms and their antibiotic sensitivity pattern.

Method: Total 224 type1 and type 2 diabetic patients, age > 18 years with or without symptoms of UTI with significant bacteriuria were enrolled in the study. Diagnosis of UTI was made on the basis of clinical history, symptoms and detailed clinical examination and confirmed by urine examination. Other investigations (CBC, serum creatinine, blood urea, HBA1C, fasting and post meal blood sugar and USG abdomen with pelvis) were also done. In addition, the organisms in urine cultures and antibiotic sensitivity patterns were investigated for bacteriuric patients.

Results: The highest numbers of patients were of fever 105 (46.67%) followed by asymptomatic UTI [98; 43.56%]. The presence of anemia and leucocytosis had statistically no significant association with UTI while poor glycaemic control has statistically significant association with UTI in diabetic patients. E. coli (32.14%) was commonest microorganism isolated in urine culture. Gram negative organisms were mostly sensitive to Imipenem, Piperacillin-tazobactam and Nitrofurantoin while gram positive bacteria were mostly sensitive to Linezolid, Nitrofurantoin, Vancomycin, Tetracyclin, Clindamycin and Azithromycin and showed increased resistance to Fluroquinolones and Cotrimoxazole. Candida sp. was sensitive to Fluconazole, Itraconazole.

Conclusion: UTI was more commonly associated in elderly diabetics with female predominance. The observed trends in clinical and laboratory profile, causative organism patterns, and antimicrobial susceptibilities will help to reduce morbidity and mortality.