Asymptomatic Urinary tract infection among diabetic patients admitted at a tertiary care hospital of Karachi
Keywords:Diabetes, Urinary Tract Infection, Antibiotic, Resistance, Insulin, Oral Hypoglycemic Agents.
Objective: To determine frequency of urinary tract infection among asymptomatic diabetics, the etiological agents, antibiotic sensitivity and the pattern of antibiotic resistance to that organism. Methodology: This cross-sectional study was conducted at Taj Medical Complex, Hamdard University Hospital, and Karachi. A total of 395 patients with Diabetes Mellitus were enrolled in our study. All data were transformed in a structured Performa. All lab analysis plus Urine C/S were done with written consent from the patients. Data was maintained and analyzed on SPSS version 20. Results: Among the 395 included patients, 44 % (174) were females and 56 % (221) were males. 362 were taking oral hypoglycemic agents (OHA), 9 were under insulin and 24 were taking both insulin and OHA. The mean HbA1c was 8.08 ± 1.29. Out of 395 samples of urine C/S of asymptomatic diabetic patients, 242 samples showed growth of organisms more than 105 CFU (colony forming units). The most common organism in 160 (66.11%) cases was E.coli. The other organisms isolated were klebsiella in 37 (15.28%) cases, staph aureus in 30 (12.4%), proteus in 7 (2.3%), enterococcus in 8 (3.3%) case. UTI was found more common in those patients who were taking oral hypoglycemic agents as compared to those who were taking insulin. E-coli- was sensitive to ciprofloxacin in 88.75%, ceftriaxone in 67.9% and imipenum in 100%. Klebsiella was 100% sensitive to ciprofloxacin. It was also 100% sensitive to imipenum. Staph aureus was sensitive to ciprofloxacin in 70%cases and 77% sensitive to ampicillin. E.coli was resistant to ampicillin, cefixime and gentamycin. Klebsiella was resistant to ceftriaxone and pimpedic acid. Staph aureus was resistant to co-trimoxazole. Proteus was resistant to imipenum in 100% cases and enterococci were resistant to amikacin in 100% cases. Conclusion: The study concluded that the prevalence of UTI is higher in females as compared to males in asymptomatic diabetic patients. E.coli was the foremost etiological agent of UTI. It was also observed that the diseases incidence increases with increasing age and vice versa. Because of the frequency and severity of UTI in diabetes, prompt diagnosis and early treatment is compulsory to prevent consequent complications.