Prevalence, risk factors and microorganisms of urinary tract infections in patients with type 2 diabetes mellitus: a retrospective study in China

Abstract

BackgroundUrinary tract infections (UTIs) occur more frequently in diabetic patients. This study was conducted to investigate the prevalence, risk factors and microorganisms of UTIs in Chinese patients with type 2 diabetes (T2D).Patients and methodsA total of 3,652 Chinese inpatients with T2D were reviewed and data on their clinical characteristics, symptoms of UTIs, random blood glucose, HbA1c, glutamic acid decarboxylase antibody, insulin autoantibody, albumin excretion rate in 24-hour urine, urine culture and susceptibility to antibiotics, and so on were collected. Binary logistic analysis was performed to look for risk factors of UTIs.ResultsThere were 409 (11.2%) patients suffering from UTIs. Gender, age, random blood glucose, insulin autoantibody and albumin excretion rate in 24-hour urine were the risk factors of UTIs in diabetic patients. The percentage of positive urine cultures was higher in the asymptomatic bacteriuria patients than in symptomatic patients (P<0.001). The incidence of septicemia was considerable in the UTIs and asymptomatic bacteriuria groups. Escherichia coli was the most common pathogenic microorganism isolated in diabetic patients with UTIs, and one-half of the E. coli infections were multidrug resistant. Furthermore, meropenem was the most effective antibiotic on E. coli.ConclusionWe suggest that a routine urine analysis or urine culture should be conducted in patients with T2D diabetes who have the identified risk factors. The UTIs might affect the islet function or blood glucose control in patients with T2D. Before a doctor decides to prescribe antibiotics to a diabetic patient with UTIs, the drug sensitivity test should be performed.

Asymptomatic Bacteriuria in Type II Diabetics and non Diabetics: Risk factors, Bacterial types and their corresponding resistance pattern

“…Analysis of the results showed that the risk of ASB is higher among diabetics especially female than their nondiabetic counterparts, in agreement with previous studies (11,12,19,21,27,28). Among the 220 diabetic patients, 9.55% were positive for bacterial growth which is lesser than studies done in different countries (20,25,27,28), similar to results obtained by Worku et al, in Ethiopia (22) and higher than those reported in China (3.7%) by Ke et al (19).…”

“…In the previous study in the Saudi diabetic population, Al-Rubeaan et al reported that hypertension and insulin therapy were found to be the significant risk factors for ASB (30). E. coli (41.7%) was the predominant pathogen isolated from urine samples followed by K. pneumoniae (25%) in agreement of different studies in many countries such as China, Nigeria, Bangladesh, Jordan, Sudan and Romania (19,23,24,25,27,28). While Nabaigwa et al in their study in Uganda found that the most uropathogen isolated was S. saprophyticus, followed by E. coli (13).…”

“…In the current study, patient age, duration of DM, insulin treatment and hypertension were not found to be associated with increasing risk for developing ASB. Reports for diabetic patients in Saudi Arabia and other studies have been noted with similar results (19,27). Meanwhile, previous studies reported that age, DM Table 3.…”

The prevalence of urinary tract infections in type 2 diabetic patients: a systematic review and meta-analysis

“…It should be noted that there is a difference of opinion regarding the effect of diabetes duration and blood sugar control on UTI. The study of vismanthan2009 linked the duration of diabetes to UTI, but not to the study of He2018 (28,36). The relationship between blood sugar control and UTI is also highly controversial.…”

“…The association between diabetes, urinary tract infection and gender has been well established [11]. In a 2018 study in China, out of 1,072 women with type 2 diabetes in the study, 341 people were infected and of the 1,783 men with type 2 diabetes in the study, only 68 people had a urinary tract infection (28). In connection with the study of venmans2009, in which the prevalence rate of UTI in men is higher than in women, it is necessary to provide the necessary explanations.…”