Spectrum of uropathogens and their antibiotic sensitivity pattern in diabetes mellitus patients at a tertiary care hospital in Odisha, India

Abstract

Background: Diabetes Mellitus is the most common endocrine disorder involving almost all systems of body. Untreated or poorly treated Diabetics are susceptible to develop a series of complications responsible for raised morbidity and mortality. Diabetes Mellitus has a number of long term effects on the Genitourinary system. Urinary tract infections have long been recognised as a significant problem in patients with Diabetes Mellitus.Methods: Prospective observational study. Diabetic patients with culture positive UTI were included. Gestational diabetes, Immunocompromised patients and patients with congenital renal anatomical abnormalities were excluded.Results: Authors included 211 numbers of culture positive UTI among diabetic patients. Out of which, 65 were male and 146 were female. Maximum number of patients belong to 56-65 years age group. Escherichia coli was the predominant organism isolated. Gram positive organisms showed 100% sensitivity to Vancomycin and Linezolid. Gram negative organisms showed 100% sensitivity to Polymyxin B.Conclusions: Genitourinary tract infection is not an infrequent complication seen in diabetes patients. Most common causative organism and their antibiotic sensitivity pattern should be done in tertiary care hospital for a better antibiotic policy.

Frequency of urinary tract infection and antibiotic sensitivity of uropathogens in patients with diabetes

“…The reason for the variation in sensivity pattern might be nature of organism and the use of antibiotics without restrictions. Gram positive isolates were showed high sensitivity (100%) towards Vancomycin in our as well as in two Indian studies 11,16. All gram positive pathogens showed least sensitivity towards Norfloxacin in present study similar to Indian study 16…”

“…E.coli showed most higher sensitivity towards Imipenem and Piperacillin / Tazobactam (100%) in current study also supported by local studies as compared to earlier studies 75%, 68.5%, 98% 6,10,11-13. It also shown high sensitivity (100%) towards Nitrofurantoin, in an Ethiopian study similarly (93.24%) in current study as well as in studies from Nepal and India, Whereas 80.3% in another studies 7,16-19…”

“…Previous study showed high frequency of E.coli 80% whereas it was 65%, 49% and 60.5% in studies from Nepal and Burma, respectively 6,10,17,18. K.pn was found 7.48% in current study whereas it was as high 25.1% and 18.7% in earlier studies 16,19. Similarly 14%,13.8%,11% of K.pn isolates were found from local, Burma, and Nepal studies, respectively 15,17,18.…”

“…UTI in female 87.85% in present study which is in agreement with other studies. The main reason might be anatomical predisposition as compared to male, which allow access of bacteria to the bladder and poor personal hygiene 10,15,16. Most of the patients with diabetes (35.18%) with UTI age ranges 51-60 in our study.…”

“…Piperacillin / Tazobactam showed high sensitivity towards all urinary isolates in our as well as in another local study 6. All the isolated bacteria were 100% sensitive to nitrofurantoin in Ethiopian and Indian studies 7,16. The reason for the variation in sensivity pattern might be nature of organism and the use of antibiotics without restrictions.…”