Asymptomatic bacteriuria as a predictor of subsequent hospitalisation with urinary tract infection in diabetic adults: The Fremantle Diabetes Study

Karunajeewa, Harin; Mcgechie, D.; Stuccio, G.; Stingemore, Neil; Davis, Wendy A.; Davis, Timothy

doi:10.1007/s00125-005-1794-3

Cited by 33 publications

(26 citation statements)

References 11 publications

(25 reference statements)

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“…The mean creatinine level did not differ in diabetic subjects with or without ASB in three cross-sectional surveys (pooled difference 0.21 μmol/l [95% CI −0.3 to 0.8]; P = 0.36) (7,11,19). Association of proteinuria and ASB was studied in three trials (10,19,20).…”

Section: Resultsmentioning

confidence: 94%

“…Although ASB has been found to associate with increased risk of hospitalization for urosepsis in a prospective observational study among women with diabetes (7), the treatment of ASB in one randomized controlled trial did not reduce the risk of symptomatic urinary tract infection (8). Associations between ASB, metabolic control of diabetes, and impaired renal function have been brought up repeatedly (9–15).…”

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confidence: 99%

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Meta-Analysis of the Significance of Asymptomatic Bacteriuria in Diabetes

et al. 2010

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OBJECTIVETo evaluate whether asymptomatic bacteriuria (ASB) is more common in patients with diabetes than among control subjects. In addition, we wanted to clarify the clinical significance of ASB in patients with diabetes.RESEARCH DESIGN AND METHODSWe conducted a systematic review and meta-analysis of published data since 1966. Twenty-two studies fulfilled the inclusion criteria of the meta-analysis.RESULTSASB was present in 439 of 3,579 (12.2%) patients with diabetes and in 121 of 2,702 (4.5%) healthy control subjects. ASB was more common both in patients with type 1 diabetes (odds ratio 3.0 [95% CI 1.1–8.0]) and type 2 diabetes (3.2 [2.0–5.2]) than in control subjects. The point prevalence of ASB was higher in both women (14.2 vs. 5.1%; 2.6 [1.6–4.1]) and men (2.3 vs. 0.8%; 3.7 [1.3–10.2]) as well as in children and adolescents (12.9 vs. 2.7%; 5.4 [2.7–11.0]) with diabetes than in healthy control subjects. Albuminuria was more common in patients with diabetes and ASB than those without ASB (2.9 [1.7–4.8]). History of urinary tract infections was associated with ASB (1.6 [1.1–2.3]).CONCLUSIONSWe were able to show that the prevalence of ASB is higher in all patients with diabetes compared with control subjects. We also found that diabetic subjects with ASB more often had albuminuria and symptomatic urinary tract infections.

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Section: Resultsmentioning

confidence: 94%

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confidence: 99%

Meta-Analysis of the Significance of Asymptomatic Bacteriuria in Diabetes

et al. 2010

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“…17,70 However, investigators found that the treatment among women hospitalized for diabetes has not reduced the pervasiveness of asymptomatic bacteriuria. 71 Research studies also substantiated the relation between asymptomatic bacteriuria, diabetes and impaired kidney function. 72,73 Many other researchers have attempted to unveil the association between asymptomatic bacteriuria and diabetes and have successfully revealed the alliance of asymptomatic bacteriuria and the host factors among women with diabetes.…”

Section: Diabetes and Utimentioning

confidence: 89%

Urinary Tract Infection: An Overview of the Infection and the Associated Risk Factors

Ramachandran¹

2014

JMEN

133

132

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IntroductionUrinary tract infection is a common contagion among men and women but the incidence is quite high among women due to their physiology. In simple terms, it can be referred as a condition which women will certainly encounter during the span of their life time and the prevalence is higher among women during pregnancy. As the name indicates, the infected parts involve the urinary tract comprising of the upper and lower urinary tract. The infection is named after the part that gets infected and is referred to as cystitis (bladder infection) and phylonephritis (kidney infection). The symptoms associated with the bladder and kidney infections are contrasting which includes painful and frequent urination in case of cystitis as a result of bladder infection whereas conditions like high fever and flank pain are commonly experienced in case of kidney contagion which is referred to as phylonephritis. This prevalence of the infection among children and elderly people is not clearly understood and is currently under study. Bacteria are the prime perpetrator responsible for conferring the infection among humans but the role of certain fungi and viruses cannot be over looked. However, the incidence of UTI as a result of viral or fungal infection is considered to be rare phenomena. Though the infection seems to be harmless in the initial stages, the patient shows a variety of symptoms as the stage progresses and can lead to death in severe circumstances. Research studies have defined urinary tract infection as the most common form of bacterial infection.1,2 Urinary tract infection can be a consequence of poor diagnosis and is regarded as the common hospital acquired infection. 3,4 The infection encompasses a diverse group of clinical syndromes and diseases that differ in epidemiology, etiology, location severity of the condition. 5 In addition to the above factors, it also vary in expressed local symptoms, frequency of recurrence, extent of damage caused, presence of complicating factors and the risk from their reiterate incidence. 6 The occurrence of bladder infection is usually followed by kidney infection and results in blood borne infection and in severe circumstances can lead to dire consequences including death. Therefore, UTI is capable of claiming lives under severe circumstances and proper treatment results in quick recovery from the contagion. The onset of the infection is in the 6 th week of pregnancy through 24 th week. 7 Although the prevalence of bacteriuria during pregnancy is similar to that in non pregnant women, pregnancy enhances the possibility of infection among women. 8,9 The occurrence of the infection is at its peak during pregnancy which in turn relies on several other factors. Though the higher incidence of UTI during pregnancy cannot be accepted as a universal fact as the concept is under the verge of research and several researchers are attempting to figure out the significance of pregnancy in relation to urinary tract infection. The concept of the predominance of UTI among women during pr...

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“…A number of predisposing factors for ASB have been reported. In most [99][100][101][102] but not all [103] studies, there is no relationship between glycaemic control and ASB. Chronic complications such as nephropathy and neuropathy have been associated with ASB in type 1 but not type 2 diabetes [99,104], a pattern that holds for longer diabetes duration [104].…”

Section: Urinary Tract Infectionsmentioning

confidence: 97%

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

Peleg

Weerarathna

McCarthy

et al. 2006

Diabetes Metabolism Res

496

406

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SummarySpecific defects in innate and adaptive immune function have been identified in diabetic patients in a range of in vitro studies. However, the relevance of these findings to the integrated response to infection in vivo remains unclear, especially in patients with good glycaemic control. Vaccine efficacy seems adequate in most diabetic patients, but those with type 1 diabetes and high glycosylated haemoglobin levels are most likely to exhibit hyporesponsiveness. While particular infections are closely associated with diabetes, this is usually in the context of extreme metabolic disturbances such as ketoacidosis. The link between glycaemic control and the risk of common community-acquired infections is less well established but could be clarified if infection data from large community-based observational or intervention studies were available. The relationship between hospital-acquired infections and diabetes is well recognized, particularly among post-operative cardiac and critically ill surgical patients in whom intensive insulin therapy improves clinical outcome independent of glycaemia. Nevertheless, further research is needed to improve our understanding of the role of diabetes and glycaemic control in the pathogenesis and management of community-and hospitalacquired infections.

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Asymptomatic bacteriuria as a predictor of subsequent hospitalisation with urinary tract infection in diabetic adults: The Fremantle Diabetes Study

Cited by 33 publications

References 11 publications

Meta-Analysis of the Significance of Asymptomatic Bacteriuria in Diabetes

Meta-Analysis of the Significance of Asymptomatic Bacteriuria in Diabetes

Urinary Tract Infection: An Overview of the Infection and the Associated Risk Factors

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

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