Incidence and risk factors associated with urinary tract infection in diabetic patients with and without asymptomatic bacteriuria

Abstract

In order to compare the incidence of symptomatic urinary tract infection (UTI) in diabetic patients with and without asymptomatic bacteriuria (ASB), and to identify other risk factors for these infections, 289 females and 168 males were studied over a 12-month period. Symptomatic UTI occurred in 69.2% of patients with ASB (67.6% female and 76.5% male) versus 9.8% without ASB (14.9% female and 2.6% male). ASB and urinary incontinence were associated with symptomatic UTI in both women and men. Other risk factors included previous antimicrobial treatment and macrovascular complications in women and obesity and prostatic syndrome in men. The presence of ASB was found to be the major risk factor for developing symptomatic urinary tract infection. Further prospective randomized clinical trials of diabetic patients with risk factors for UTI who are receiving or not receiving treatment may be considered.

Urinary tract infections in Romanian patients with diabetes: prevalence, etiology, and risk factors

“…These findings are in agreement with those in previous reports suggesting an association between elevated HbA1c levels and the presence of UTIs 19,20. Ribera et al found that a HbA1c level >7% was associated with symptomatic UTIs in patients with DM,15 but this variable did not remain a risk factor when logistic regression analysis was applied. Other reports also have not found a correlation between metabolic control and the presence of UTIs 5,12,16–18,21…”

“…The presence of ASB is a major risk factor for developing symptomatic UTIs,15 the present study identifying ASB as the most prevalent type of UTI in patients with DM (9%), with a prevalence similar to that reported in other previous studies. A meta-analysis of 22 studies regarding ASB in patients with DM has shown a prevalence of ASB of 12.2%, higher in females (14.2%) than in males (2.3%),16 similar to the present study’s findings.…”

“…The association between chronic kidney disease and UTIs has been studied in the literature especially regarding the increased albumin excretion rate, with microalbuminuria or macroalbuminuria being incriminated as risk factors for the occurrence of UTIs 12,18. The association found in this study between the macrovascular complications of DM (coronary artery disease) and the risk of occurrence of UTIs was also demonstrated in other studies 15,17…”

Prevalence of Uropathogens in Diabetic Patients and Their Corresponding Resistance Pattern: Results of a Survey Conducted at Diagnostic Centers in Dhaka, Bangladesh

“…3 The incidence of diabetes mellitus (DM) throughout the world is increasing strikingly and is becoming a serious public health problem especially in the developing countries. 4 Diabetes mellitus is associated with many complications and in the long run it has some major effects on the genitourinary system which makes diabetic patients more liable to UTI and particularly to upper urinary tract infections. 5 …”

Reducing Antibiotic Overuse: A Call for a National Performance Measure for Not Treating Asymptomatic Bacteriuria

“…Prospective, observational studies performed in Spain and Australia [5,6] indicated that ASB is the major risk factor for the development of complications, such as symptomatic UTI (including sepsis), in diabetic patients. However, a placebo-controlled, double blind, prospective clinical trial [7] performed in the United States that involved diabetic women failed to conclude that treatment of ASB reduces such complications.…”