Pattern of uropathogens and antibiotic sensitivity in diabetes patients attending to out – Patient department and diabetes clinic of a teaching hospital

Abstract

Introduction: Diabetes mellitus is the most common endocrinological disease associated with different life-threatening infections. Urinary Tract Infection is one of them which may lead to Intensive care Unit admission and even death. In this study, we would like to find out the spectrum of uropathogen and its antibiotic sensitivity, so that we can choose empirical antibiotics early to save lives. Aim and Objectives: To find out spectrum of uropathogens in Diabetic patients attending to Diabetes Clinic of a tertiary hospital and to find out the Antibiotic sensitivity pattern in isolated bacteria. Material and Methods: In this cross-sectional observational hospital-based study, consecutive patients of any age and gender having Diabetes mellitus and symptoms of Urinary Tract Infection, who attended Out-patient Department and Diabetes Clinic of General Medicine Department from August 2020 to October 2020, were included. After taking consent and brief history, mid-stream clean catch urine sample was collected in sterile container and sent to a Microbiology laboratory for culture of micro-organism and sensitivity to antibiotics. Results: Among 202 diabetic patients recruited in our study, 138 (68.31%) were female and 64 (31.69%) were male. The mean age of all participants was 50.23 ± 11.45 years. Culture confirmed UTI was 24.3% and patients showing classic UTI symptoms were 32.7%. Compared to male, most of the culture-positive and symptomatic patients were female (26.0% and 37% respectively). Culture-positive patients who showed classic UTI symptoms were 42.42%; however, we found 15.44% asymptomatic patients who showed culture positivity. The mean HbA1c level was 7.5 ± 1.6%. Subgroup analysis revealed that patients with HbA1c >7.5% were at a significantly higher risk of developing culture-positive UTI ( P < 0.00001, Odds ratio 21.71). Prevalence of gram-negative and gram-positive bacteria were 65.3% (32 out of 49) and 28.57% (14 out of 49), respectively. The major organism isolated were Escherichia coli (39%), Klebsiella spp . (19%), Enterococcus spp . (12%), Staphylococcus aureus (12%), and Candida spp . (6%). The sensitivity pattern of the gram-negative bacilli showed the presence of Extended-spectrum betalactamases (ESBLs) in 36.84% (11 out of 32 isolates). The bacteria grown were most sensitive to Piperacillin-tazobactam (100%), Cefoperazone-sulbactam (100%) and Meropenem (100%) whereas Fluoroquinolone and Co-Amoxyclav showed least sensitivity (43.8% and 37.5% respectively). The Staphylococcus spp. showed 100% sensitivity to Vancomycin, Teicoplanin, Linezolid whereas Penicillin-G and Ampicillin showed 12.5% sensitivity. The Enterococcus spp. revealed 100% sensitivity to Vancomycin, Teicoplanin, Linezolid, and Fosfomycin. Drug resistance is emerging in c...

Prevalence of Drug Resistant Uropathogenic &lt;i&gt;Escherichia coli&lt;/i&gt; from Immunocompromised Diabetic Patients Attending Selected Health Facilities in Benue State

“…The results of antibiotic susceptibility pattern from Otukpo revealed E. coli to be moderately susceptible to streptomycin 60%, cefotaxime 55% and imipenem 50% while at the same time showing moderate to high resistance to cotrimoxazole 50%, tetracycline 55%, ceftriaxone 60%, ciprofloxacin 65%, ofloxacin 70%, nalidixic acid 70%, levofloxacin 80%, aztreonam 80%, ampicillin 80%. This was contrary to a study in India [36] who reported complete sensitivity (100%) to imipenem but comparable resistant pattern has been observed in Ethiopia to nalidixic acid 70% and cotrimoxazole 64.7% [26].…”

Evaluation of uropathogens isolated in the outpatient department of a tertiary care hospital in south India

“…16 study from Nath, et al found that there is an increase of antibiotic drug resistance associated with oral formulations, especially fluoroquinolones and Ampicillin, used in OPD cases. 17 Our results echo similar findings of Nath, et al and found an increase in drug resistance, largely to fluoroquinolones and cephalosporins. Our results coincide with other studies, as we isolated similar common uropathogens including E.coli (60%), Klebsiellaspp (18.6%) and Pseudomonasspp (14%).…”

Nitrofurantoin Susceptibility Profile on Bacterial Isolates from Urinary Tract Infection in Patients with Diabetes Mellitus

“…Studies at Banjarmasin represent Escherichia coli (65.3%) and Pseudomonas aeruginosa (11.5%) as the majority etiology (20). This result is similar to another study in Kalyani, India, that shows the most common bacteria in diabetic patients with UTI is Escherichia coli (38.77%) (12). jurnal.umj.ac.id/index.php/MMJ mmjfkk@umj.ac.id e-issn: 2721-317X Muhammadiyah Medical Journal Nitrofurantoin susceptibility testing towards Escherichia coli is that five isolates are sensitive, five are intermediate, and two are resistant.…”

“…Drug-resistant UTIs are emerging in community and healthcare setups (12). Some studies reported the effects of drug resistance are deaths, length of hospitalization, and healthcare costs (13).…”