Urinary tract infections in patients with diabetes mellitus. Studies on antibody coating of bacteria

Forland, Marvin

doi:10.1001/jama.238.18.1924

Cited by 38 publications

(23 citation statements)

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“…We found no association between neuropathy and urosepsis, but neuropathic bladder dysfunction, together with leucocyte dysfunction, and enhanced bacterial replication and uroepithelial adhesion, may also have played a role [1]. ACR was an independent predictor of urosepsis in our patients and the presence of nephropathy may have in- creased the risk of clinically silent renal parenchymal infection that led to urosepsis [10]. Nevertheless, nonurinary sepsis as a principal diagnosis was also associated with ACR, suggesting that patients with microangiopathy are at increased risk of severe infections in general.…”

Section: Discussioncontrasting

confidence: 47%

Asymptomatic bacteriuria as a predictor of subsequent hospitalisation with urinary tract infection in diabetic adults: The Fremantle Diabetes Study

et al. 2005

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Aims/hypothesis: We examined the prognosis of well-characterised community-based diabetic patients with asymptomatic bacteriuria (ASB). Methods: We studied 496 adults with type 1 or 2 diabetes participating in a prospective observational study. In addition to detailed clinical and laboratory data, a single mid-stream urine sample was taken for aerobic culture and antibiotic-sensitivity testing. ASB was defined as ≥10 5 colony-forming units/ml of one or two organisms without symptoms of urinary infection. Patients were followed for 2.9±0.6 years for hospital admission for/with urosepsis or death. Results: Thirty-six patients (7.3%) had ASB, comprising 33 females (14.4% of all females) and three males (1.1% of all males). Only female sex predicted ASB amongst a range of variables including indices of metabolic control. Twentynine patients (5.8%) were subsequently hospitalised with urosepsis. Of these, urosepsis was the principal diagnosis in 12 (41%). In a Cox proportional hazards model, ASB was associated with an increased risk of hospitalisation for urosepsis as principal diagnosis (hazard ratio [95% CI] 4.4 [1.2-16.5]; p=0.004). ASB did not predict the combined endpoint of hospitalisation with urosepsis as principal or secondary diagnosis (2.3 [0.8-6.7]; p=0.12), or of non-urinary sepsis as principal (n=12) or principal/secondary (n=28) diagnosis (p>0.3). Conclusions/interpretation: ASB identifies diabetic patients who are at significantly increased risk of subsequent urosepsis requiring hospitalisation. Further large-scale studies are needed to establish the cost-effectiveness of screening for, and pre-emptive treatment of ASB, especially in females.

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Section: Discussioncontrasting

confidence: 47%

Asymptomatic bacteriuria as a predictor of subsequent hospitalisation with urinary tract infection in diabetic adults: The Fremantle Diabetes Study

et al. 2005

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“…The adherence of E.coli (type1-fimbriated) to uroepithelial cells of women with DM is increased, compared with the adherence to uroepithelial cells of women without DM 14 . However, the bacteria isolated from diabetic patients with UTI are similar to those found in nondiabetic patients with complicated UTI 7 . It has been reported that E.coli to be a causative uropathogen in 47% of the UTI in diabetic patients and in 68% of the UTIs in nondiabetic patients 8 Table 5.…”

Section: Introductionsupporting

confidence: 53%

“…Most investigators report that the prevalence of asymptomatic bacteriuria (ASB) in women with DM is three to four times higher than in women without DM 6 . This was differing in the case of males in which the results were more consistent; a frequency between 1 and 2% has been found, with no difference between diabetic and nondiabetic men 7 . Also, the frequency of symptomatic infections in women with DM is also increased 8 .…”

Section: Introductionmentioning

confidence: 79%

Prevalence of urinary tract infection in diabetic patients and identification of the causal microorganisms

Ahmed

2013

ZJMS

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Background and objective: Urinary tract infection (UTI) is a condition in which the urinary tract is infected with a pathogen causing inflammation. One of the predisposing factors for UTIs is diabetes mellitus (DM), spillage of glucose into the urine provide a good culture medium for bacteria. The objectives of this study were to evaluate the distribution of UTIs among diabetic patients of both genders with studying the effect of some relative factors, and identifying types of the causal microorganisms. Methods: Diabetic patients (type1 and 2), from both genders were included in this study. All patients were interviewed. Uncontaminated urine samples were collected for microscopic and macroscopic analysis. Isolations and identifications of bacteria were done by standard methods. Results: Out of 150 diabetic patients, 53 (35.33%) have UTI. Gender, middle age and high level of proteinuria were risk factors, while type and duration of DM with its type of treatment, body mass index (BMI), and hypertension were non significant. The isolated types of pathogens were Escherichia coli (45.3%), Klebsiella pneumoniae (15.1%), Staphylococcus saprophyticus (15.1%), Citrobacter diversus (11.3%), Candida albicans (7.5%) and Staphylococcus aureus (5.7%). Conclusion: This study revealed that diabetic females were most susceptible to get UTIs than diabetic males. In both genders the most reliable age for UTI were between 31-40 years. The results showed that the level of proteinuria was higher in patients suffering from UTIs associated with DM, which considered as a risk factor. Certain types of microorganisms were isolated; the most common types were Escherichia coli, Klebsiella pneumoniae and Staphylococcus saprophyticus.

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“…Upon completion of the experiment, we noted that histopathological as well as the immunofluorescence and ultrastructural studies showed more prominent pathological changes with earlier onset of the features. Experimental models of infections in rabbits, rats, and mice with chemically induced diabetes have shown increased susceptibility to various bacterial and fungal infections [3,[5][6][7]. Some studies to the contrary have shown no increased susceptibility to infection [8].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Diabetes on Acute Post-Infectious Glomerulonephritis in Rats: An Experimental Study with Literature Review

Kfoury¹,

Alsuwaida²,

Alghonaim³

et al. 2017

J Clin Exp Nephrol

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Background: The concurrence of diabetes and nephritogenic infections may have a tremendous impact on the kidney. The approach to the two concurrent diseases is based on histological, immunofluorescence findings and most importantly on ultrastructural features. In this experiment our aim was to compare the pattern of injury seen in the kidney in animals with induced post-infectious glomerulonephritis with and without associated diabetes.

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Urinary tract infections in patients with diabetes mellitus. Studies on antibody coating of bacteria

Cited by 38 publications

References 0 publications

Asymptomatic bacteriuria as a predictor of subsequent hospitalisation with urinary tract infection in diabetic adults: The Fremantle Diabetes Study

Asymptomatic bacteriuria as a predictor of subsequent hospitalisation with urinary tract infection in diabetic adults: The Fremantle Diabetes Study

Prevalence of urinary tract infection in diabetic patients and identification of the causal microorganisms

The Impact of Diabetes on Acute Post-Infectious Glomerulonephritis in Rats: An Experimental Study with Literature Review

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