Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group.

Geerlings, Suzanne E.; Stolk, Ronald P.; Camps, Marielle J.L.; Netten, P. M.; Hoekstra, J B L; Bouter, K.P.; Bravenboer, Bert; Collet, J. Theo; Jansz, Arjen R.; Hoepelman, Andy I. M.

doi:10.2337/diacare.23.6.744

Cited by 194 publications

(113 citation statements)

References 41 publications

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“…For diabetes-specific variables, most [1][2][3] but not all [8] studies have found 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 diabetic patients [1,7], a pattern that also holds for longer diabetes duration [7]. In some of these studies, a small sample size and restricted number of variables limit the conclusions that could be drawn.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of both nondiabetic and diabetic women have found an association between ASB and subsequent symptomatic UTI [7], but we focused on morbidity severe enough to justify hospitalisation. The association between ASB and urosepsis is strengthened by the observation that our patients with and without ASB had a similar risk of future hospitalisation for non-urinary sepsis, suggesting that ASB is more than a non-specific marker of host susceptibility to bacterial infection.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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Aims/hypothesis: We examined the prognosis of well-characterised community-based diabetic patients with asymptomatic bacteriuria (ASB). Methods: We studied 496 adults with type 1 or 2 diabetes participating in a prospective observational study. In addition to detailed clinical and laboratory data, a single mid-stream urine sample was taken for aerobic culture and antibiotic-sensitivity testing. ASB was defined as ≥10 5 colony-forming units/ml of one or two organisms without symptoms of urinary infection. Patients were followed for 2.9±0.6 years for hospital admission for/with urosepsis or death. Results: Thirty-six patients (7.3%) had ASB, comprising 33 females (14.4% of all females) and three males (1.1% of all males). Only female sex predicted ASB amongst a range of variables including indices of metabolic control. Twentynine patients (5.8%) were subsequently hospitalised with urosepsis. Of these, urosepsis was the principal diagnosis in 12 (41%). In a Cox proportional hazards model, ASB was associated with an increased risk of hospitalisation for urosepsis as principal diagnosis (hazard ratio [95% CI] 4.4 [1.2-16.5]; p=0.004). ASB did not predict the combined endpoint of hospitalisation with urosepsis as principal or secondary diagnosis (2.3 [0.8-6.7]; p=0.12), or of non-urinary sepsis as principal (n=12) or principal/secondary (n=28) diagnosis (p>0.3). Conclusions/interpretation: ASB identifies diabetic patients who are at significantly increased risk of subsequent urosepsis requiring hospitalisation. Further large-scale studies are needed to establish the cost-effectiveness of screening for, and pre-emptive treatment of ASB, especially in females.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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“…Furthermore, it is not possible to distinguish between type 1 and type 2 diabetes because patients in both groups could receive a treatment with insulin. This division is, for this study, not that important because in an earlier study (21) we showed a comparable incidence of UTI in patients with type 1 and type 2 diabetes. Unfortunately, because we did not have urine culture results, we were not able to distinguish between a relapse and a reinfection, which could have influenced the subsequent treatment decision.…”

Section: Secondary Analysesmentioning

confidence: 98%

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

Schneeberger

Stolk

DeVries³

et al. 2008

Diabetes Care

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OBJECTIVE -Women with diabetes have a high incidence and complication rate of urinary tract infections (UTIs). Our aims were to compare current treatment strategies with respect to recurrence rates in women with diabetes with those without diabetes.RESEARCH DESIGN AND METHODS -We used a Dutch registration database containing pharmacy dispensing data. A total of 10,366 women with diabetes (17.5% premenopausal) (aged Յ55 years) and 200,258 women without diabetes (68% premenopausal) who received a first course of trimethoprim, nitrofurantoin, fosfomycin, or norfloxacin between January 1999 and January 2006 were included. We compared short (Յ5 days) with long (Ͼ5 days) prescriptions and norfloxacin with trimethoprim, nitrofurantoin, and fosfomycin. A recurrence was defined as a second prescription for one of the above-mentioned agents or a first with amoxicillin (clavulanic acid), fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after inclusion.RESULTS -Premenopausal women with diabetes more often received a long (26.5 vs. 19.2%; P Ͻ 0.001) treatment with norfloxacin (10.7 vs. 6.2%; P Ͻ 0.001) but still had a higher recurrence rate (16.1 vs. 12.2%; P ϭ 0.003) compared with those without diabetes. Similarly, postmenopausal women with diabetes more often received a longer (32.8 vs. 28.8%; P Ͻ 0.001) treatment with norfloxacin (15.2 vs. 12.7%; P Ͻ 0.001) but had a higher recurrence rate (19.1 vs. 16.4%; P Ͻ 0.001) compared with those without diabetes.CONCLUSIONS -Despite the fact that patients with diabetes more often received longer and more potent initial treatment than patients without diabetes, pre-and postmenopausal women with diabetes more often had recurrences of their UTIs.

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“…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]. ASB is more frequent in patients with cardiac and peripheral vascular disease [105].…”

Section: Urinary Tract Infectionsmentioning

confidence: 99%

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

Peleg

Weerarathna

McCarthy

et al. 2006

Diabetes Metabolism Res

499

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 may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group.

Cited by 194 publications

References 41 publications

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

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

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

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

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