Similarities in Bacterial Uropathogens and Their Antimicrobial Susceptibility Profile in Diabetics and Their Non-Diabetic Caregivers at a National Diabetes Management and Research Centre, Accra-Ghana

Abstract

Background: Diabetes mellitus has some damaging effects on the genitourinary system and has been found to have adverse effects on the host immune system, resulting in higher risk of infections including urinary tract infections (UTI). Incidences of UTI caused by bacteria have been increasingly reported globally and the abuse of antibiotics leading to evolving resistant strains of antibiotics is a public health challenge for the management of this condition. Information on the difference in types of bacterial agents causing UTI in diabetic patients and non-diabetic individuals, and their susceptibility profiles, will facilitate effective management among these groups of patients. Therefore, this study aimed at determining the difference in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility profiles in diabetic patients and non-diabetic individuals at a diabetes management center. Methods: This was a prospective cross-sectional study conducted amongst 100 diagnosed diabetic patients and 100 non-diabetic individuals. Urine sample was collected aseptically and analyzed microbiologically for the presence of urinary tract bacterial pathogens. Drug susceptibility testing was conducted on the isolates by the Kirby Bauer method to ascertain the antibiotic susceptibility patterns. Results: Among the diabetic and non-diabetic individuals, urinary tract bacterial pathogens were observed in 28.0% and 26.0% of samples, respectively. The organisms were in the following proportions for diabetic and non-diabetic individuals, respectively: E. coli (14/28, 50% and 8/26, 30.7%), S. aureus (2/28, 7.1% and 4/26, 15.4%), K. pneumoniae (4/28, 14.3% and 8/26, 30.7%), K. ozoenae (2/28, 7.14% and 0/26, 0%), K. oxytoca (0/28, 0% and 4/26, 15.4%) and C. urealyticum (6/28, 21.4% and 2/26, 7.69%). The difference between the proportions of bacteria isolated was, however, not statistically significant (p-value = 0.894). Bacteria isolated from both diabetic and non-diabetic individuals were highly susceptible to most of the antibiotics tested, especially nitrofurantoin, cefuroxime, ceftriaxone, and cefotaxime. Conclusion: This study has shown that similarities exist in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility patterns amongst diabetic patients and non-diabetic individuals at a diabetes management center. These data will help in the management of UTI among these individuals.

Antimicrobial susceptibility pattern of pathogens from urinary isolates of diabetic patients in a tertiary care hospital in South Tamil Nadu

“…Gram-negative enteric organisms including Escherichia coli, Klebsiella species, and Proteus species, which frequently cause urinary tract infections, are typically implicated in bacterial research. 15,17 Similarly, Gramnegative pathogens were more frequently isolated than Gram-positive ones. Escherichia coli was found among the diabetic patients, with Klebsiella, Pseudomonas aeruginosa, Proteus species, Citrobacter freundii, Acinetobacter species, Enterococcus species, Staphylococcus aureus, and CoNS being the next most common bacteria.…”

“…Escherichia coli was found to be the most often growing organism in both diabetes and non-diabetic subjects in a research that was identical to the one from India (34.92% and 29.09%). 15 A greater propensity for Escherichia coli adherence has been seen in diabetic individuals with poor glycemic control. 16 Patients with diabetes had a little greater percentage prevalence of uropathogens than nondiabetics, who had a prevalence of 36.6%; however, this difference was not statistically significant.…”

Prevalence of β-lactamase enzyme producing uropathogenic E.coli isolates amongst diabetic and non-diabetic patients

“…The efficacy of these antibiotics attributed to the fact that these drugs are not easily available and are relatively expensive as compared to other drugs in the study. Therefore, these drugs could be considered as therapeutic options in the empirical treatment of UTI in both diabetic and nondiabetic population [35].…”

Particularities of Urinary Tract Infections in Diabetic Patients: A Concise Review

“…The study conducted by Wang et al on 271 E. coli strains isolated from urine samples (190 from diabetic and 81 from non-diabetic patients) reported a similar antimicrobial resistance profile between diabetic and non-diabetic patients, excepting a higher resistance rate to the second-and third-generation cephalosporins in the diabetic patients [44]. In addition, Owusu et al conducted a prospective cross-sectional study including 100 diagnosed diabetic patients and 100 non-diabetic individuals that showed that bacterial strains isolated from both diabetic and non-diabetic individuals were highly susceptible to most of the antibiotics tested, especially nitrofurantoin, cefuroxime, ceftriaxone, and cefotaxime [46].…”