Systematic Review of Literature Examining Bacterial Urinary Tract Infections in Diabetes

Abstract

This systematic review addresses the central research question, “what is known from the published, peer-reviewed literature about the impact of diabetes on the risk of bacterial urinary tract infections (UTI)?” We examine the results from laboratory studies where researchers have successfully adapted mouse models of diabetes to study the pathophysiology of ascending UTI. These studies have identified molecular and cellular effectors shaping immune defenses against infection of the diabetic urinary tract. In addition, we present evidence from clinical studies that in addition to diabetes, female gender, increased age, and diabetes-associated hyperglycemia, glycosuria, and immune impairment are important risk factors which further increase the risk of UTI in diabetic individuals. Clinical studies also show that the uropathogenic genera causing UTI are largely similar between diabetic and nondiabetic individuals, although diabetes significantly increases risk of UTI by drug-resistant uropathogenic bacteria.

Bacterial abundance and antimicrobial resistance patterns of uropathogens among pregnant women with asymptomatic bacteriuria: Association with glycemic status

“…We found that gram-negative bacteria were more prevalent, with Escherichia coli and Klebsiella pneumoniae being the predominant isolate, in both groups. Similar to us several other investigations evaluating ASB have found a higher proportion of Gram-negative uropathogens, in both normoglycemic and hyperglycemic pregnant women [5] , [7] , [8] , [9] , [10] , [11] . However, few have found a predominance of Gram-positive bacteria including Staphylococcus, also [3] .…”

“…Additionally, we found a higher prevalence of ASB in women with GDM. The majority of prior research has reported a higher prevalence of ASB in diabetics [5] but to date, sufficient robust studies have not explored ASB in pregnant women with GDM. Scant available literature has revealed conflicting results.…”

“…Diabetes mellitus (DM) and gestational diabetes mellitus (GDM), whose prevalence is rapidly increasing worldwide, have been found to be an important risk factor for urogenital infections and deteriorating outcomes of infectious disorders [4] , [5] . Hyperglycemia and infection pose double trouble in pregnancy as both independently cause not only short-term fetomaternal complications but can also lead to foetal programming and adverse long-term fetomaternal consequences [4] , [6] .…”

Characteristics of Nationwide Urinary Tract Infection (UTI) Visits by Age and Type II Diabetes Status in Women

“…Neither age group in our study had drastically different T2DM rates compared to national T2DM rates, around 11.3%, as reported by the CDC [ 15 ]. We expected higher rates of T2DM in our populations because of the well-established notion that individuals with T2DM are at an increased risk for UTIs [ 4 ]. This finding could result from our limited sample size, especially for individuals with T2DM.…”

Promising Materials in the Fight against Healthcare-Associated Infections: Antibacterial Properties of Chitosan-Polyhedral Oligomeric Silsesquioxanes Hybrid Hydrogels

“…Although some measures such as the control of sterility in operating rooms [ 10 ] and antibiotic prophylaxis [ 11 ] are able to reduce the incidence of these infections, these strategies cannot completely eradicate the risk of infection. Furthermore, some conditions can increase the clinical severity, including obesity, poor nutritional status, and comorbidities such as rheumatoid arthritis and diabetes mellitus [ 12 , 13 ]. Moreover, an important feature about devices-related infections is that causative strains, including Gram-positive [e.g., Enterococcus faecalis , Staphylococcus aureus including methicillin-resistant strains (MRSA), Staphylococcus epidermidis , and other coagulase-negative staphylococci (CoNS)] and Gram-negative bacteria (e.g., Klebsiella pneumonia , Pseudomonas aeruginosa , Acinetobacter baumannii , Escherichia coli , and Proteus mirabilis ), are often able to produce biofilm [ 14 , 15 ].…”