Asymptomatic Bacteriuria in Diabetic Adults

Abstract

Introduction: Urinary Tract Infection (UTI) is a well- known complication of Diabetes Mellitus (DM). Its spectrum ranges from Asymptomatic Bacteriuria (ABU) to acute pyelonephritis. Many studies have delineated an increased prevalence of ABU in DM whereas to the same degree other studies have come to naught showing insignificant association. Hence, this study was drafted to evaluate the presence of ABU among diabetics and assess various risk factors.
 
 Methods: Total of 116 diabetic adults without symptoms of UTI attending medical out-patient department, Manipal Teaching Hospital were enrolled by detailed clinical history, examination and laboratorial examination as per standard set of questionnaire from February 2013 to May 2014. Data were analyzed by SPSS (17.0).
 
 Results: The rate of ABU in diabetic adults was 10.3% and was significantly associated with duration of DM, fasting blood glucose level and poor glycaemic control. Escherichia coli was the most frequently isolated pathogen which was sensitive to Nitrofurantoin and Imipenem.
 
 Conclusion: Being asymptomatic, diabetics fail to recognise ABU, however, ABU is preponderant in DM and is linked mainly with duration of DM and poor glycaemic control. Hence screening for ABU is imperative in diabetic adults if above mentioned risk factors are present.

A comparative study of the prevalence of asymptomatic bacteriurea (ASB) among elderly diabetics and non diabetics with their antibiotic resistant pattern

“…The prevalence of ASB among elderly diabeticswas 9.8% and 4.6% in non diabetics. This result was very similar with the study done by BK Jha et al (9.43%), 18.4% in study done by Manish Rijal et al and 10.3% by A. Adhikari et al [7][8][9] Butin some study prevalence of ASB in diabetic patients was comparatively higher. 10,11 The most common microorganisms in this study was Escherichia coli, 53.8% in diabetics 66% in non diabetics followed by Klebsiella, pseudomonas, staphylococcus, coagulase negative staphylococcus.…”

“…Among 11 Gram negative bacteria only 1 was resistant to Imipenem that was pseudomonas isolated from the urine sample of diabetic patients, age 72 with the mean HbA1c levels significantly higher and was multidrug resitant. Nitrofurantoin was the sensitive antibiotics after the Imepenem, against the urinary isolates similar pattern was also reported in a study of Manish Rijal et al 9 Most isolated microorganisms were resistant to Amoxyclav and Norfloxacin. Gram positive bacteria were sensitive to Vancomycin and Teicoplanin.…”

Asymptomatic bacteriuria among the patients of type 2 diabetes mellitus

“…Ajay Adhikaree et al in their study included 116 diabetic adults and observed that overall prevalence of ASB was 10.3% and patients with poor glycemic control had higher prevalence of ASB in comparison to those with good glycemic control. [ 10 ]…”

“…[ 6 ] In another study conducted by Adhikaree et al , E. coli was the most frequently isolated pathogen (75%), followed by Klebsiella (16.7%) and Staphylococcus aureus . [ 10 ]…”

“…[ 6 ] In the study by Adhikaree et al , E. coli was the most frequently isolated pathogen (75%), followed by Klebsiella (16.7%), and E. coli was most sensitive to NFT and imipenem, while Klebsiella was most sensitive to ciproflocin/norfloxacin, cotrimoxazole, and imipenem. [ 10 ]…”