Recent trends in the antimicrobial susceptibility patterns of urinary pathogens in type II diabetes mellitus

Abstract

Background: Diabetes mellitus is one of the most frequently encountered diseases in clinical practice and since the diabetic patients are at an increased risk of infections specially those of the urinary tract it is imperative for a physician to be aware of the prevalence and antibiotic susceptibility patterns of urinary pathogens. Thus, in this study we assess the recent trends in antimicrobial susceptibility patterns of urinary pathogens in type II diabetes mellitus.Methods: Ninety-three eligible type II diabetes mellitus cases without genitourinary symptoms or abnormalities along with 93 non-diabetic healthy controls were recruited. Mid-stream urine was collected after taking informed consent and each sample tested using the dipstick, microscopy and culture techniques. Isolates were identified using standard biochemical tests.Results: Prevalence of asymptomatic bacteriuria (ASB) in our study was found to be 34.4% among cases of type II diabetes mellitus while it was 6.45% among non-diabetic healthy controls. E. coli was the most common urinary pathogen isolated. E. coli susceptibility towards amikacin was 85.71%, towards ceftriaxone and nitrofurantoin was 71.73% and for meropenem and doxycycline 66.67% susceptibility was observed. In the one case where pseudomonas was cultured, it was susceptible to meropenem, gentamycin, cefoperazone-sulbactum and cefuroxime. In an isolated case where Proteus species was grown, it showed susceptibility to meropenem, norfloxacin, levofloxacin and co-trimoxazole. Enterobacter species which was grown, showed susceptibility to meropenem, vancomycin, amikacin, nitrofurantoin, norfloxacin, levofloxacin and co-trimoxazole. Gram positive bacteria mainly showed susceptibility to ceftriaxone, teicoplanin, vancomycin and doxycycline.Conclusions: The prevalence of bacteriuria is significantly higher in diabetics as compared to non-diabetics and with the recent trends suggestive of emerging resistance among urinary pathogens to some of the commonly used anti-microbials it is of utmost importance to carry out regular surveillance of bacterial profile and their anti-microbial susceptibilities to formulate updated guidelines for effectively treating urinary infections in diabetic patients.

Frequency and risk factors of UTI and susceptibility pattern of uropathogen and impact of glycaemia control among diabetic patients.

“…Similar findings were observed from many other studies. 3,5,10,18,19,20 E coli was also the most common organism isolated in urinary culture of Diabetic 87% and non-diabetic group 54.5% in Viral R Dave et study. 3 In Nureen Zahra et al study E. coli was detected in 60% Diabetic patients and 32%in nondiabetic patients.…”

“…10 The most common organism isolated was E. coli in 22.58% Diabetics and in 5.38% among healthy control group in Gurjar D et al study. 5 In the Md. Hamza Saber et al study the rate of E. coli isolation in the diabetic males and females (57.5% and 63.8%) was lower than nondiabetic male and female [83.3% and 76.1%].…”

“…Diabetes mellitus (DM) is the serious and common endocrine disease 1 have several etiologies characterized by increased plasma glucose levels with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. 2 The rate of morbidity and mortality and its prevalence has risen dramatically worldwide 3,4,5 especially for lower middle-income countries. In Pakistan its prevalence was predicted to increase 67% from 2010 to 2030.…”

“…3 It is the most common microbial disease affecting people of all ages and its prevalence varies 0.7% to 20% worldwide. 7,8 UTI is the common infection observed in patients with DM 5 and about 35% patients are reported highly susceptible to it. 7,8 Poor bladder function, obstruction in urinary flow and incomplete voiding are commonly found in patients with diabetes increasing the risk of UTI.…”

“…3,7,8,9 There was an increase in antimicrobial resistance found among uropathogens both in community and hospital settings causing difficulty in the treatment of UTI. 3,5 Multi drug resistance (MDR) bacteria were E.Coli and Klebsiella Pneumoniae. 3 The present study is designed to determine the frequency and risk factor of urinary tract infection in patients with or without diabetes and to determine antimicrobial susceptibility among type 2 subjects with controlled and uncontrolled glycemia.…”