Pattern and Presentation of Urinary Tract Infection in Diabetic and Non Diabetic Population

Abstract

Background : Urinary tract infection (UTI) is a frequent infection encountered in diabetics as well as in the general population. Both in community and hospital settings, antimicrobial resistance among uropathogens causing UTI is also increasing and studies have shown incidence of resistance to be higher in Diabetics. Objective: This current study was undertaken to compare the clinical presentation of UTI and antibiotic sensitivity profile of uropathogens in diabetics and non-diabetics. Methods: This is a cross-sectional analyticial study in 100 diabetics and 100 non Diabetics with culture positive UTI from January 2014 to July 2015. Patient demographics, symptoms of the infection, detailed medical history ,laboratory data like urine routine, urine culture ,antibiotic sensitivity and ultrasound abdomen were collected. statistical analysis was done using SPSS. Results: 100 diabetic and 100 non-diabetic patients with culture positive UTI were enrolled in our study. The mean age of diabetics was 56.9 yrs and non diabetics was 50.02 yrs. E.coli was the commonest organism isolated in Diabetics (56%) and Non Diabetics (71%). Klebsiella was the second commonest organism isolated in both groups. Staphylococcus (7%) and Candida (4%) were exclusively isolated in Diabetic group (Fischer’s exact p test: 0.007). ESBL producers were more frequently seen in diabetics when compared to non Diabetics (p value=0.041). When the antibiotic resistance pattern in E.coli was compared between diabetics and nondiabetics, we demonstrated E.coli isolated from Diabetics showed significantly higher resistance (p<0.05) to Cephalosporins. Antibiotic sensitivity of E.coli for Amikacin, PipercillinTazobactem, Gatifloxacin and Gentamicin was better in Non Diabetics (p<0.05) in comparison to diabetic groups. Conclusion: The presentation of UTI was similar in diabetics and non-diabetics groups. E.coli was the commonest organism isolated in diabetics (56%) and non-diabetics followed by Klebsiella. ESBL producers were more frequently observed in diabetics .Isolates of E.coli from diabetics and non diabetics have demonstrated a higher resistance pattern to Cephalosporins and better sensitivity pattern to Nitrofurantoin, Amikacin, PipercillinTazobactem, Gatifloxacin and Gentamicin.