A COMPARATIVE CROSS-SECTIONAL STUDY OF THE CLINICAL AND MICROBIOLOGICAL PROFILE OF URINARY TRACT INFECTIONS IN DIABETICS AND NONDIABETICS- A HOSPITAL BASED STUDY.

Dr. BHALACHANDRA. S. PATWARDHAN; Dr. DEEPAK GUPTA

Volume : IX, Issue : VI, June - 2020

A COMPARATIVE CROSS-SECTIONAL STUDY OF THE CLINICAL AND MICROBIOLOGICAL PROFILE OF URINARY TRACT INFECTIONS IN DIABETICS AND NONDIABETICS- A HOSPITAL BASED STUDY.

Dr. Bhalachandra. S. Patwardhan, Dr. Deepak Gupta

Abstract :

INTRODUCTION In developing countries like India, infections are common presenting manifestations of Diabetes and urinary tract infection being the commonest. Impaired immunity, poor metabolic control, incomplete bladder emptying (autonomic neuropathy) and emergence of infections by resistant pathogens may all contribute. The objective of the study is to compare the clinical and microbiological profile of urinary tract infections among the diabetic and the non–diabetic group. METHODOLOGY All the patients above the age of 18 years visiting our hospital with symptoms of urinary tract infection, satisfying the inclusion criteria, after an informed consent were studied with regards to their symptoms and the diagnostic workup for urinary tract infection. A sample size of 150 with 75 patients each of Diabetic and Non–diabetic were compared and analysis done using appropriate statistics. RESULTS Diabetics showed a higher incidence of lower urinary tract infection symptoms with higher level of blood leucocytosis (p= 0.026) and urinary abnormalities ( urine leucocytes p=0.007 , ketonuria p = 0.023, proteinuria p= 0.004) compared to non–diabetics. Incidence of complicated UTI was also more among the Diabetics as compared to Non–diabetics (cystitis 28% vs 8% p < 0.001, pyelonephritis 10.66% vs 5.35%, renal abscess 5.3% in diabetics). The most common cause of UTI was E.coli followed by Klebsiella, Proteus, Staph aureus, Pseudomonas , Enterococci and Coagulase negative staphylococcus in descending order but there wasn’t significant difference in the spectrum of organisms among the two groups. The uropathogens showed higher levels of resistance against the commonly used antibiotics in Diabetics. CONCLUSIONS Although the microorganisms causing UTI in Diabetics are similar to the ones causing infection in the Non–diabetic population, yet they exhibit a surprisingly different antibiotic sensitivity pattern. Hence it is imperative to cautiously evaluate any episode of urinary tract infection in the diabetic population and have a complete microscopic and culture profile of urine done so as to provide the antibiotic with maximum efficacy.