A clinical study of urinary tract infections in diabetics and non-diabetics patients

Vinod, C. Sayee Sankar; Nareddy, Vishnu Anjan; Nagabhushana, M. V.

doi:10.18203/2349-3933.ijam20193683

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…The antimicrobial resistance pattern was similar in participants of both the groups with maximum sensitivity to Colistin and minimum sensitivity to Amoxicillin. This is in agreement with the other Indian[ 15 16 17 21 23 24 25 ] and South Asian studies. [ 18 26 27 28 ] Diabetics had relatively lesser symptoms and more severe forms of UTI at presentation and less favorable outcomes.…”

Section: Discussionsupporting

confidence: 93%

“…In agreement with the previous studies,[ 14 15 16 17 21 22 ] Escherichia coli (56.8%), followed by Klebsiella pneumoniae (25.2%) were the most common organisms isolated from both groups, whereas Proteus sp. and Pseudomonas sp.…”

Section: Discussionsupporting

confidence: 92%

“…In terms of symptoms, subjects without diabetes reported “fever” to be frequent, wherein diabetics had “vomiting” and “retention,” etc., to be commonly associated with UTIs. Only a few studies[ 15 16 17 ] devoted their attention to the symptomatology of UTIs in comparison of diabetics and nondiabetics and they concluded that fever followed by dysuria be consistent with both groups. It is enlightening that one need not expect diabetics to showcase fever when they suffer from UTIs of any severity, making it imperative for GPs/Clinicians to actively screen for the same to initiate empirical therapy at the earliest.…”

Section: Discussionmentioning

confidence: 99%

“…Not surprisingly, “indwelling urethral catheter” was found to be the most common identified predisposing factor for UTI among both diabetics and nondiabetics followed by benign prostatic hypertrophy (BPH) as in agreement with the previous studies. [ 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

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Urinary tract infection and Diabetes Mellitus—Etio-clinical profile and antibiogram

Jagadeesan

Tripathi

Patel

et al. 2022

Journal of Family Medicine and Primary Care

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Context: A complex dysregulation of glucose homeostasis, Diabetes Mellitus (DM) is an iceberg disease with an ever-rising global (8.5%, 2018) and national prevalence (7.3% - ICMR-INDIAB study, 2017) amidst adults. Besides the micro and macrovascular complications, in virtue of diverse mechanisms that downplay the immune system culminating in an array of infections especially UTIs are commoner in routine diabetic clinics. The spectrum of UTI ranges from asymptomatic bacteriuria (ASB) to serious complications such as emphysematous pyelonephritis, renal abscesses that are encountered frequently among Diabetics than the general population. The risk stratification and varying modalities of presentation of UTIs in diabetics in contrast with non-diabetics are being studied. Methods and Material: A prospective comparative cross-sectional study was conducted in 250 adult consenting participants with equal diabetics and non-diabetics with culture-proven UTI, at the Department of Internal Medicine in a tertiary care hospital of National Capital Territory (NCT) of India, after fulfilling appropriate criteria. Alongside socio-demographic details and vitals parameters, glycaemic status assessment and relevant investigations were done in either group. Results: Mean age of the participants was 52.18 ± 9.06 with age and gender being reasonably distributed in both the groups. Fever ( P <0.01), dysuria ( P <0.01), urgency ( P <0.01) and urinary frequency ( P <0.01) found frequently among non-diabetics wherein vomiting ( P <0.01) and incontinence ( P <0.01) relatively commoner among diabetics. E. coli, Klebsiella sp., were the most common organisms in both groups with Proteus sp., and Pseudomonas sp., higher among diabetics. Severe infection and Pyelonephritis were frequent (AOR 2.64, 95% CI- 2.01-3.27, P <0.05) among diabetics. Antimicrobial sensitivity patterns were not significantly different among both groups. Conclusions: Primary care physicians are to be acquinted with the possibility that UTI in diabetics could exhibit relatively lesser symptoms or more severe forms of UTI at presentation and less favorable outcomes. Further validation from a larger cohort of diabetics is warranted in terms of symptomatology, diagnostic approach, and sensitivity patterns.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Urinary tract infection and Diabetes Mellitus—Etio-clinical profile and antibiogram

Jagadeesan

Tripathi

Patel

et al. 2022

Journal of Family Medicine and Primary Care

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“…A study by Bonadio et al in 2000 found that in diabetic individuals with a culture-confirmed UTI, 52.8% of cases were recurrent infections, while the recurrence rate was 42.9% in the non-diabetic group, although the difference did not reach statistical significance [ 16 ]. Another study from 2019 by Vinod et al found that 14.4% of UTI cases were recurrent in diabetic individuals with urine culture-confirmed UTIs, while this rate was 10.5% in the non-diabetic group [ 17 ]. The differences between these rates and our findings are likely due to variations in study populations as both Bonadio et al and Vinod et al included both type 1 and type 2 diabetics, did not exclude men, and used patient populations of varying age ranges.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Nationwide Urinary Tract Infection (UTI) Visits by Age and Type II Diabetes Status in Women

Papp,

Christie,

Zimmern

2023

Cureus

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Background Through a national database search of office visits, we studied the contribution of two known risk factors for urinary tract infections (UTIs) in women: age and type 2 diabetes mellitus (T2DM). Methodology The National Ambulatory Medical Care Survey (NAMCS) database was queried for visits including a UTI diagnosis and a urine culture order. Data were included for all visits involving adult women for available years, 2014-2016 and 2018. Data on demographics, reason for visit, T2DM status, UTI workup, and UTI treatment were collected. Patients with Alzheimer’s disease or chronic kidney disease were excluded. Descriptive statistics were displayed as weighted means with standard errors for continuous variables. The effect of age was compared based on a 65-year-old cutoff. Results One hundred sixty-seven surveyed visits were analyzed for the years 2014-2016 and 2018, representing an estimated 7.4 million visits nationwide. Women ≥65 years were more likely to be white, non-Hispanic/non-Latino, from the Midwest or West, from metropolitan areas, and on Medicare/Medicaid than their younger counterparts. T2DM and urinalysis rates did not significantly vary between the two age groups (7.7% vs. 14.6%, P = 0.3; 78% vs. 76%, P = 0.9, respectively). For urinalysis rates between patients with and without T2DM, there was no significant difference in the <65-year-old group (80% vs. 78%, P = 0.9) or the ≥65-year-old group (93% vs. 73%, P = 0.12). Antibiotic prescription rates were also similar for T2DM and non-T2DM patients (67% vs. 75%, P = 0.7). Conclusions Through a national database analysis, we reported the demographic and visit differences aged <65 years and ≥65 years who sought care for UTIs in the United States over a four-year period. T2DM rates and urinalysis did not vary between age groups, and urinalysis rates and antibiotic prescription rates did not vary between T2DM and non-T2DM groups in an age-dependent matter. More research is needed to understand the demographic makeup and risk factors of UTI patients across the nation.

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Assessment of early kidney injury caused by asymptomatic bacteriuria in children with type 1 diabetes

et al. 2022

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Introduction Infection is one of the most frequent causes of morbidity and mortality in diabetic patients. Some microorganisms become more virulent in a high glucose concentration. Diabetics are more likely to have asymptomatic and symptomatic bacteriuria. NGAL is secreted in high concentrations into the blood and urine within two hours of AKI. Objectives The aim of the study is early detection of UTI in type1diabetic children through screening of their urine samples, and measurement of NGAL urinary levels in cases with asymptomatic bacteriuria for early detection of AKI to prevent serious complications. Patients and methods One thousand twenty-two known diabetic children on regular follow up in endocrine outpatient clinic at Minia Children University hospital were screened for UTI. From them only 52 diabetic children were diagnosed as asymptomatic bacteriuria (group I), 52 diabetic children with normal urine analysis (group II) and 52 apparently healthy children, age and sex matched, served as controls (group III). CBC, Renal function test, HbA1c, hs- CRP, Albumin/creatinine ratio, urine examination, urine culture, GFR and urinary NGAL were done to all children. Results Thirty-seven females (71.2%) had asymptomatic bacteriuria, Hs CRP and urinary NGAL were significantly higher, while GFR was significantly lower in diabetic children with bacteriuria than the other two groups. For diabetic children with bacteriuria, (AUC) for NGAL was 1 with optimal cutoff value of > 44.1 (Sensitivity 100% and Specificity 100%) while AUC for hsCRP was 0.887 with optimal cutoff value of > 1 (Sensitivity 82.69% and Specificity 90.38%). Conclusion Routine urine analysis should be done for all diabetic children even if they are asymptomatic. NGAL and hsCRP are non-invasive methods that could detect early renal injury in these patients thus, early, and proper management of UTI should be started to prevent renal injury.

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A clinical study of urinary tract infections in diabetics and non-diabetics patients

Cited by 4 publications

References 10 publications

Urinary tract infection and Diabetes Mellitus—Etio-clinical profile and antibiogram

Urinary tract infection and Diabetes Mellitus—Etio-clinical profile and antibiogram

Characteristics of Nationwide Urinary Tract Infection (UTI) Visits by Age and Type II Diabetes Status in Women

Assessment of early kidney injury caused by asymptomatic bacteriuria in children with type 1 diabetes

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