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  • Title: Asymptomatic bacteriuria and symptomatic urinary tract infections (UTI) in patients with diabetes mellitus in Tikur Anbessa Specialized University Hospital, Addis Ababa, Ethiopia.
    Author: Yeshitela B, Gebre-Selassie S, Feleke Y.
    Journal: Ethiop Med J; 2012 Jul; 50(3):239-49. PubMed ID: 23409407.
    Abstract:
    BACKGROUND: The risk of urinary tract infection in diabetic patients is higher and the etiology and the antibiotic resistance of uropathogens have been changing over the past years. OBJECTIVE: The aim of this study was to determine the prevalence of symptomatic and asymptomatic bacteriuria and assess the antimicrobial susceptibility pattern of the isolates in diabetic patients. METHODS: A prospective study was conducted during June to August 2009 on diabetic in and out-patients in Tikur Anbessa University Hospital. A total of 413 consented adult patients were enrolled in the study. Two consecutive clean-catch midstream urine samples from diabetic subjects were collected for culture. Disc diffusion method was used to assess the antimicrobial susceptibility patterns of the isolates. RESULTS: Of the 413 diabetic patients participated in the study, 181 (43.8%) were males and 232 (56.2%) were females. Of these, 107 (25.9%) were type 1 and 306 (74.1%) were type 2 diabetes mellitus. Nine (13.6%) of the symptomatic diabetic patients had bacteriuria compared with 36 (10.4%) of asymptomatic diabetes patients had bacteriuria. The overall prevalence of urinary tract infection in the diabetic patients was 45 (10.9%). The predominant isolates were Escherichia coli and Klebsiella pneumoniae isolated in 6% and 28% followed by 2% and 6% in symptomatic and asymptomatic diabetic patients, respectively. Over 85% of Escherichia coli isolates were sensitive to ciprofloxacin, amoxicillin-clavulanic acid, ceftazidime, nitrofuranton, ceftiraxone, norfloxacin and geamicin. Klebsiella pneumoniae were 100% sensitive to ciprofloxacin, ceftazidime, ceftriaxone. The rate of resistance to two or more antimicrobials was 33 (71.7%). CONCLUSION: The prevalence of urinary tract infection in this study was higher in women than in men. Escherichia coli was frequently isolated in both symptomatic and asymptomatic patients. Over 60% of the isolates were resistant to ampicillin, trimethoprim-sulphamethoxazole and tetracycline. Investigation of bacteriuria in diabetic patients for urinary tract infection is important for treatment and prevention of the development of renal complications.
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