Prevalence of Urinary Tract Infections in Diabetic Patients

Open access

Abstract

Background and aims: There is evidence that patients with diabetes have an increased risk of asymptomatic bacteriuria and urinary tract infections (UTIs). UTI is the most common bacterial infection in diabetic patients. The aim of this study was to assess the prevalence of UTIs among hospitalized diabetic patients and to identify the most frequent bacteria responsible for UTI. Material and methods: The study population included 1470 diabetic patients (847 women and 623 men), admitted to the Diabetes Clinic of the Emergency Clinical County Hospital Timişoara, between January and December 2012. We collected patients’ personal history data and performed urine cultures. For statistical analysis we used Graph Pad Prism 5; the significance of the difference between the percentage values was assessed using Fisher’s exact test. Results: From the total number of patients, 158 had positive urine cultures, meaning 10.7%. Out of the total number of 158 UTIs, 124 (78.4%) were asymptomatic bacteriuria. The most frequent bacteria involved in UTI was Escherichia coli (68.9%). Conclusion: UTIs are frequent in diabetic patients. Because of the great proportion of asymptomatic forms among diabetic patients, the urine culture should be performed in all hospitalized patients with diabetes.

1. Zimmet P. Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 414: 782-787, 2001.

2. International Diabetes Federation. IDF Diabetes Atlas, 5th edition Update, 2012, http://www.idf.org/diabetesatlas/5e/Update2012.

3. International Diabetes Federation. IDF Diabetes Atlas, 5th edition, 2011, http://www.idf.org/diabetesatlas/5e/the-global-burden.

4. World Health Organization. WHO The top 10 causes of death. Fact sheet Nr. 310. Updated June 2011, http://www.who.int/mediacentre/factsheets/fs310/en/index.html.

5. US Renal Data System. USRDS 2004 Annual Data Report. The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, 2004.

6. American Diabetes Association. Position statement. Standards of medical care in diabetes 2012. Diabetes Care 35: S11-S63, 2012.

7. de Boer IH, Rue TC, Hall YN, Heagerty PJ,Weiss NS, Himmelfarb J. Temporal trends in the prevalence of diabetic kidney disease in the United States. JAMA 305: 2532-2539, 2011.

8. National Kidney Foundation. KDOQI. Clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification, 2002. http://www.kidney.org/professionals/kdoqi/guidelines_ckd/p4_class_g3.htm.

9. Chin-Hong PV. Infections in patients with diabetes mellitus: importance of early recognition, treatment, and prevention. Adv Stud Med 6: 71-81, 2006.

10. Muller LMAJ, Gorter KJ, Hak E et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis 41: 281-288, 2005.

11. Boyko EJ, Fihn SD, Scholes D, Abraham L,Monsey B. Risk of urinary tract infection and asymptomatic bacteriuria among diabetic and nondiabetic postmenopausal women. Am J Epidemiol 161: 557-564, 2005.

12. Boyko EJ, Lipsky BA. Infection and diabetes. In: Diabetes in America, 2nd Edition. Harris MI (ed). National Diabetes Data Group, Bethesda, pp 485-499, 1995.

13. Ribera MC, Pascual R, Orozco D, PérezBarba C, Pedrera V, Gil V. Incidence and risk factors associated with urinary tract infection in diabetic patients with and without asymptomatic bacteriuria. EurJ Clin Microbiol Infect Dis 25: 389-393, 2006.

14. Geerlings SE, Stolk RP, Camps MJ et al. Risk factors for symptomatic urinary tract infection in women with diabetes. Diabetes Care 23: 1737-1741, 2000.

15. World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: Report of a WHO/IDF Consultation, Geneva, World Health Org., 2006, http://whqlibdoc.who.int/publications/2006/9241594934_eng.pdf.

16. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. WHO/NCD/NCS/99.2 ed. Geneva, World Health Organization, 1999, http://whqlibdoc.who.int/hq/1999/who_ncd_ncs_99.2.pdf.

17. Renko M, Tapanainen P, Tossavainen P,Pokka T, Uhari M. Meta-analysis of the significance of asymptomatic bacteriuria in diabetes. Diabetes Care 34: 230-235, 2011.

18. Zhanel GG, Nicolle LE, Harding GKM. Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group ClinInfect Dis 21: 316-322, 1995.

19. Bonadio M, Costarelli S, Morelli G,Tartaglia T. The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection. BMC Infect Dis 6: 54, 2006.

20. Goswami R, Bal CS, Tejaswi S, Punjabi GV,Kapil A, Kochupillai N. Prevalence of urinary tract infection and renal scars in patients with diabetes mellitus. Diabetes Res Clin Pract 53: 181-186, 2001.

21. Wheat LJ. Infection and diabetes mellitus. Diabetes Care 3: 187-197, 1980.

22. Lipsky BA. Urinary tract infections in men. Epidemiology, pathophysiology, diagnosis, and treatment. Ann Intern Med 110: 138-150, 1989.

Romanian Journal of Diabetes Nutrition and Metabolic Diseases

The Journal of Romanian Society of Diabetes Nutrition and Metabolic Diseases

Journal Information


CiteScore 2018: 0.19

SCImago Journal Rank (SJR) 2018: 0.128
Source Normalized Impact per Paper (SNIP) 2018: 0.229

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 1266 1070 62
PDF Downloads 485 451 29