A clinical prediction rule for urinary tract infections in patients with type 2 diabetes mellitus in primary care

Abstract

SUMMARYWe aimed to develop a prediction rule for urinary tract infections (UTIs) in patients with type 2 diabetes mellitus (DM2). A 12-month prospective cohort study was conducted in patients with DM2 aged o45 years to predict the occurrence of recurrent UTIs in women and lower UTIs in men. Predictors for recurrent UTI in women (n=81, 2%) and lower UTIs in men (n=93, 3%) were age, number of general practitioner (GP) visits, urinary incontinence, cerebrovascular disease or dementia. In women, renal disease was an additional predictor. The optimum corrected area under the receiver-operating curve (AUC) was 0 . 79 (95 % CI 0 . 74-0 . 83) for women and 0 . 75 (95 % CI 0 . 70-0 . 80) for men. Using a cut-off score of 4, women with a lower risk assignment had a probability of 0 . 3 % for the outcome. For a cut-off score of 6, women with a higher risk assignment had a probability of 5 . 8 %. For men these figures were 0 . 8 and 7 . 1 for a cut-off score of 2 and 4, respectively. Simple variables can be used for the risk stratification of patients.

Incidence and antibiotic prescription rates for common infections in patients with diabetes in primary care over the years 1995 to 2003

“…For that reason, we have developed prediction models for a complicated course of UTI and LRTI. 35,36 Randomized trials are needed to compare the optimal duration and the choice of treatment for common infections in diabetes. This may result in advice to use first-line antibiotics for UTI for certain patients, given over a longer period of time, and for others second-line antibiotics.…”

The prevalence of urinary tract infections in type 2 diabetic patients: a systematic review and meta-analysis

“…In connection with the study of venmans2009, in which the prevalence rate of UTI in men is higher than in women, it is necessary to provide the necessary explanations. In this study, the prevalence rate of recurrent bacterial cystitis in women was 2%, while in men the prevalence of bacterial cystitis and prostatitis was 3%, so this could be a possible cause of the discrepancy [37].…”

Management of infections in type 2 diabetes from the patient's perspective: A qualitative approach

“…Non-compliance with antibiotics may increase the resistance to antibiotics, the risk of recurrence of UTI and LRTI and also increase the accompanying risk of hospitalization and mortality [16,17]. Identifying patients at high risk of a com-plicated infection by means of prediction rules [18,19] may help nurse educators and primary care physicians to target additional efforts towards those people with T2DM in most need.…”