Prevalence of asymptomatic bacteriuria in type 2 diabetic subjects with and without microalbuminuria

Abstract

BackgroundDiabetic subjects, especially women, show high prevalence of asymptomatic bacteriuria (ASB). The aim of the present study was to evaluate the prevalence of ASB in subjects with type 2 diabetes mellitus (T2D) with and without microalbuminuria (MA).FindingsA hundred diabetic subjects with MA (53 males/47 females, mean age ± standard deviation: 65.5 ± 11.1 years) and 100 diabetic subjects without MA (52 males/48 females, mean age ± standard deviation: 65.4 ± 11.3 years), consecutively attending the outpatient diabetes clinic of our hospital were recruited in the study. Subjects with overt diabetic nephropathy or nephropathy from other causes were excluded. In addition, subjects with symptoms of urinary track infection or use of antimicrobial drugs in the last 14 days were excluded by the study.Diabetic subjects with MA showed increased prevalence of ASB compared to diabetic subjects without MA (21% versus 8%, P < 0.001, respectively). Escherichia coli was the most prevalent pathogen isolated in diabetic subjects with and without MA (12% versus 3.0%, P = 0.01, respectively) followed by Proteus mirabilis (6% versus 5%, P = 0.75, respectively) and Klebsiella spp (5% versus 1%, P = 0.09, respectively). Univariate logistic analysis showed that ASB was associated with the presence of coronary artery disease [odds ratio (OR): 0.29, 95% Confidence Intervals (95% CI): 0.09-0.95, P = 0.04] and gender (OR: 0.09, 95% CI: 0.02-0.35, P < 0.001) in the diabetic study group with MA.ConclusionsASB is more prevalent among T2D subjects with MA. Screening for ASB is warranted in diabetic patients especially if pyuria is detected in urine analysis since ASB has been found to be a risk factor for developing symptomatic urinary tract infection.

Albuminuria Is Not Associated with Bacteriuria in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Observational Studies

“…Regarding symptoms, five studies evaluated only asymptomatic bacteriuria [4,5,7,11,12], one study evaluated asymptomatic plus symptomatic [6], and one study did not report frequency of symptoms [13]. The chance for microalbuminuria or macroalbuminuria was not increased by the presence of bacteriuria in a sensitivity analysis including only studies that evaluated asymptomatic bacteriuria (OR: 1.71, 95% CI: 0.89–3.30, I 2 = 71.7%).…”

“…However, the possible association between bacteriuria and increased urinary albumin is controversial. Some cross-sectional studies observed an increased prevalence of macroalbuminuria and/or microalbuminuria in patients with bacteriuria [4,5], while other studies do not support this observation [6,7]. The aim of the present study was to investigate the association of albuminuria and bacteriuria in patients with type 2 diabetes by a systematic review and meta-analysis of observational studies.…”

Bioinformatics analysis and expression of a truncated form of Proteus mirabilis Pta protein as a novel vaccine target against urinary tract infection

“…mirabilis is the most common pathogen of the urinary tract that is more common in complicated urinary tract infections, particularly in catheter-associated UTI (CAUTI) that causes about 10-44% of long-term CAUTIs [18,2]. Evidence shows that urease, hemolysin, and Pta are considered as the most important virulence factors of this uropathogen which has been involved in the urinary tract injuries in the suffering patients [19].…”

“…P. mirabilis can cause different forms of UTI including cystitis, pyelonephritis, asymptomatic bacteriuria, bacteremia, urolithiasis and progression to potentially life-threatening urosepsis [2,3]. According to the previous studies, P. mirabilis causes between 1-10% of all urinary tract infections and is the cause of 11 million physician visits and $3.5 billion dollars medical costs in the United States [3,4].…”

“…Proteus mirabilis is a Gram-negative bacteria which is an etiological cause of urinary tract infection (UTI), especially among the elderly inhabitants in nursing homes, patients with type 2 diabetes, people with a long period of catheterization, or postoperative [1,2]. P. mirabilis can cause different forms of UTI including cystitis, pyelonephritis, asymptomatic bacteriuria, bacteremia, urolithiasis and progression to potentially life-threatening urosepsis [2,3].…”