Comparison of Incidence of Urinary Tract Infection in Diabetic vs Non-Diabetic and Associated Pathogens

Abstract

Introduction Urinary tract infections (UTIs) are common in low socioeconomic country like Pakistan. There are various factors responsible for UTI, one major factor being diabetes. This study aims to compare diabetic and non-diabetic patients, for gender association, symptoms, and organisms, with UTI. Methods This cross-sectional study was conducted in the medicine ward of tertiary care hospital in Pakistan from January 2019 to December 2019. For urine analysis, freshly voided 5-10 ml of clean midstream urine specimens was collected in a sterile container. Samples were sent to the lab immediately, A colony count of ≥10 5 CFU/ml was considered for the diagnosis of UTI. Culture was done if UTI was diagnosed. Results The overall incidence of UTI in participants of the diabetic group was significantly higher than those in the non-diabetic group (13.67% vs 6.40%; P=0.004). Escherichia coli was the most common organism in both the diabetic and non-diabetic groups (60% vs 72%; P=0.73). Frequency of Klebsiella was considerably higher in the participants of diabetes but it was not significant (23.3% vs 11.1%; P=0.29). Conclusion UTI was significantly higher in the diabetic population compared to the non-diabetic population. Since diabetes is prevalent in Pakistan, care of diabetes should include reducing the risk factors for UTI.

Systematic Review of Literature Examining Bacterial Urinary Tract Infections in Diabetes

“…The comparison of percentages of causative agents of UTI between diabetic and nondiabetic individuals shows that DM does not favor urinary colonization by specific bacterial pathogens over others. Indeed, studies from Turkey [ 39 ], the Netherlands [ 40 , 41 ], France [ 42 ], and Pakistan [ 29 ] have shown that the % distribution of uropathogenic strains recovered from diabetic and nondiabetic individuals is similar, although a few studies have observed positive correlation between presence of DM and increased prevalence of certain uropathogens: (i) On a study of hospitalized patients with UTI (DM = 404; no DM = 959), Klebsiella spp. was ~2-fold more common as a uropathogen in diabetic individuals compared to nondiabetics ( P = 0.011), although there was no significant difference in the number of diabetic and nondiabetic individuals from whom UPEC, Proteus spp., Pseudomonas spp., and Enterococcus spp.…”

Uropathogens’ Antibiotic Resistance Evolution in a Female Population: A Sequential Multi-Year Comparative Analysis

“…Escherichia coli is the most common ubiquitous uropathogen in the entire population studied, in all age groups, representing a total of 54.33% of all studied pathogens, which is significantly lower than those between 60% and 90% reported in countries such as Morocco [ 25 ], Portugal [ 26 ], or Pakistan [ 27 ]. Similarly, high rates of Escherichia coli incidence were detected in Western European countries, such as France or Austria, reporting rates over 65% in the studied populations [ 28 ].…”

Prevalence and Antibiotic Sensitivity pattern of Bacterial Isolates from Catheterized UTI Patients: A Local Study

“…Diabetic nephropathy is one of the main factors that increase susceptibility of the patients to UTI when compared with non-diabetic patients. Also, the immunity is reduced in diabetic patients enhancing the risk for acquiring UTI [17].…”