Prevalence and site of bacteriuria in diabetes mellitus

Ooi, Boon Seng; Chen, Beatrice T. M.; Yu, Moses

doi:10.1136/pgmj.50.586.497

Cited by 42 publications

(7 citation statements)

References 7 publications

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“…Some early studies showed no difference between the frequency of UTI in diabetics compared to controls [9] . But more recent studies documented a two-to-threefold increase of this problem in diabetic women [10] . Kass [2] documented a 16-19% rate of bacteriuria in diabetic women compared to 5-8% in nondiabetic women.…”

Section: Discussionmentioning

confidence: 98%

Bacterial and Fungal Infections Among Diabetics

EL-sheikh¹,

Johargi²

2000

med

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ABSTRACT. One hundred and fifty specimens were collected from diabetic patients suffering from infections over a period of 9 months. Urine was the most frequently collected specimen from diabetic patients (50%) followed by foot swabs (24%), tracheal aspiration and sputum (12.7%), blood (6.7%), vaginal swabs (3.3%), and eye swabs and each stool represented 1.3%. A wide variety of gram-negative bacteria representing 12 different species were identified as the etiologic agents of infections in these specimens. Clearly, E. coli dominated over all the other species. Among the 150 microbes causing infections in diabetic patients, a total of 40 (26.7%) were identified as E. coli. Pseudomonas aeruginosa were the second bacterial species causing infections. They were isolated from 20%, followed by Klebsiella pneumoniae (9.3%), and Proteus mirabilis (4.7%). Salmonella, Enterobacter, Acinetobacter, and Citrobacter were found in 2% of the cases. Morganella (1.3%) and Serratia were detected in less than 1%. Among gram-positive bacteria, Staphylococci were the most frequent organisms and were isolated from 20 (13.3%) specimens. Other gram-positive bacteria were Streptococcus (4%), Enterococcus faecalis (2%), Micrococcus 2 (1.3%), and Diphtheroids were detected in less than 1%. Candida albicans and Candida spp. were isolated from 12 diabetic patients.

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Section: Discussionmentioning

confidence: 98%

Bacterial and Fungal Infections Among Diabetics

EL-sheikh¹,

Johargi²

2000

med

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“…However, these studies took no account of either the degree of blood sugar control or the severity of the disease. More recent studies found a two-to threefold increase in UTI incidence in diabetic women, particularly in groups with elevated blood glucose levels [12][13][14][15][16]. None of these studies showed a similar increase in risk in men [15].…”

Section: Urinary Tract Infectionsmentioning

confidence: 94%

Lower genital tract infections in diabetic women

Donders

2002

Curr Infect Dis Rep

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The influence of glucose metabolism is seen in many infectious diseases, making diabetic patients more vulnerable to sepsis and other serious sequelae of bacterial invasion. Vaginal candidiasis is a common problem if the glycemia is poorly controlled. The level of glucose concentration in the blood after ingestion of sugar seems to explain an increased likelihood of recurrent infection. Specific immune aberrations, such as an elevated T-helper 2 response and a blunted T-helper 1 response, leading to tolerance, may result in chronic recurrent vulvovaginal candidiasis. In such patients, a low-grade infection with frequent exacerbations is seen, and treatment should be based on 24-hour glycemic control and long intermittent treatment with antifungals. Besides candidiasis, there is also evidence of an increased likelihood of cystitis. Upper urinary tract infections (UTIs) are also a frequent result of bladder colonization. Lethal emphysematous nephritis due to Candida albicans or gas-forming bacteria such as Escherichia coli, Klebsiella, Proteus, streptococci, or enterococci are known to occur in diabetic patients. Furthermore, UTIs in diabetic patients are difficult to eradicate and need longer and intense antibiotic therapy. Awareness of the increased likelihood of UTIs, frequent screening, and prolonged treatment in case of cystitis are warranted. For the prevention of UTI and bacterial vaginal infections (bacterial vaginosis, vaginal atrophy with bacterial colonization, aerobic vaginitis) estrogen therapy may be as important as antibiotic therapy. Catheterization should be limited since it promotes infection more in diabetic patients than in nondiabetic patients. In the case of recurrent vaginal candidiasis, tight control of glycemia is crucial, in addition to prolonged, intermittent therapy with antifungals.

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“…Nevertheless, the reported frequency of UTI in diabetic patients is conflicting [1][2][3][4][5]. Early studies showed no difference between the frequency of UTI in diabetics compared to that in controls [4,6,7], but recent studies have documented a two-to threefold increase of UTI in diabetic women [5,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Urinary Tract Infection in Diabetic Patients

et al. 1999

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Aim: The aim of the study was to compare the epidemiological, microbiological and clinical features of diabetic patients with urinary tract infection (UTI) to those of nondiabetic ones. Methods: A prospective study was performed on 490 consecutive patients with proven UTI. The patients were studied on the basis of a specific questionnaire and hospital records. Results: Of 490 enrolled patients, 89 (18.1%) had diabetes mellitus. The mean age of diabetics and nondiabetics was respectively 64.9 ± 13.2 (SD) and 54.4 ± 23.3 years. Most diabetics had asymptomatic bacteriuria and had undergone bladder catheterization more frequently than the nondiabetics. The most frequent causative agents of UTI in diabetics and nondiabetics were: E. coli (respectively, 56.1 vs. 56.8%), Proteus sp. (7.9% vs. 7.2%), Pseudomonas sp. (6.7 vs. 8.2%), Enterococcus sp. (6.7 vs. 7.2%). More than 50% of the isolated Pseudonomas sp. strains in both groups were resistant to gentamicin, piperacillin and norfloxacin. Both diabetics (52.8%) and nondiabetics (42.2%) had recurrent UTI during the follow-up period; the difference in the incidences did not reach statistical significance. Conclusion: No significant differences in epidemiological, clinical and microbiological evaluated features of diabetics and nondiabetics were pointed out, except for the higher frequency of bladder catheterization of diabetics than nondiabetics. However, the eradication of UTI seemed to be more difficult in diabetics than in nondiabetics.

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Prevalence and site of bacteriuria in diabetes mellitus

Cited by 42 publications

References 7 publications

Bacterial and Fungal Infections Among Diabetics

Bacterial and Fungal Infections Among Diabetics

Lower genital tract infections in diabetic women

Urinary Tract Infection in Diabetic Patients

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