Study of Asymptomatic Bacteriuria in Type 2 Diabetes Mellitus Patients

Study of Asymptomatic Bacteriuria in Type 2 Diabetes Mellitus Patients

Authors

  • Ketaki Vyankatesh Kulkarni
  • Niranjan Niranjan
  • Jatin Talele

DOI:

https://doi.org/10.70284/njirm.v8i3.1236

Keywords:

Asymptomatic Bacteriuria, Escherichia coli, Leucocyturia,Type 2 diabetes mellitus

Abstract

Background & Objectives: Diabetic subjects, especially women, show high prevalence of asymptomatic bacteriuria (ASB). The risk of urinary tract infection (UTI) is higher in diabetics compared to non-diabetics. The aetiology and the antibiotic resistance of uropathogens have been changing over the past years. Hence the present study was undertaken to evaluate the prevalence of asymptomatic bacteriuria (ASB) in patients with type 2 diabetes mellitus and to find out the antibiotic sensitivity pattern of bacterial isolates. Methods: Two hundred type 2 diabetics comprising males and females (aged between 30 - 80 years) who attended Maharashtra Institute of Medical Education & Research & BSTR hospital, Pune India were included in the study. Mid-stream urines were collected from patients aseptically into sterile wide mouth container and examined microscopically for leucocyturia, and were cultured using standard techniques on blood agar, Mac Conkey agar and incubated at 37°C aerobically for 24 h. Isolates were tested against separate antibiotics for gram negative and gram positive organisms by the disc diffusion method. Results: Significant bacteriuria was observed in 52% of urine samples (50 females and 54 males) . Bacteria isolated included Escherichia coli (31%), Klebsiella pneumoniae (13%),Citrobacter koseri(13%) ,Pseudomonas aeruginosa (10%), Proteus vulgaris (3%),Acinetobacter baumannii (2%) among GNB & Staphylococcus aureus (25%) among GPCs. E.coli showed maximum sensitivity to Nitrofurantoin, while few Klebsiella and Pseudomonas isolates were sensitive to Piperacillin-tazobactum. Acinetobacter baumannii showed high resistance to all antibiotics. Among all antibiotics,majority of isolates were resistant to Ampicillin-sulbactum. 50% Staphylococcus aureus isolates showed sensitivity to Nitrofurantoin. Leucocyturia was observed in 80% patients who showed ASB. Conclusion: Finding of leucocyturia can be a clue to the screening for ASB in diabetic patients, since ASB has been found to be a risk factor for developing symptomatic urinary tract infection in these patients. [Ketaki K NJIRM 2017; 8(3):12-16]

References

1. Alebiosu CO, Osinupebi OA, Olajubu FA (2003). Significant asymptomatic bacteriuria among Nigeria type 2 diabetics. J. Nat. Med. Assoc. 95(5): 344-348.
2. Assel MT, AI-Meer FM, AI-Kuwari MG, Ismail MF (2009). Prevalence and predictor of asymptomatic bacteriuria among pregnant women attending Primary health care in Qatar Middle East. J. Fam. Med. 3. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137–49. 4. Meiland R, Geerlings SE, Stolk RP, Netten PM, Schechberfor PM, Hoepelman Al (2006). Asymptomatic bacteriuria in women with diabetes mellitus: effect on renal function after 6 years of follow- up. Archives Int. Med. 1666(20): 2222-2227. 5. Patterson JE, Andriole VT. Bacterial urinary tract infections in diabetes. Infect Dis Clin North Am. 1997;11(3):735–50. 6. Schneeberger C, Kazemier BM, Geerlings SE. Asymptomatic bacteriuria and urinary tract infections in special patient groups: women with diabetes mellitus and pregnant women. Curr Opin Infect Dis. 2014; 27(1):108–14.
7. Al-Rubeaan KA, Moharram O, Al-Naqeb D, Hassan A, Rafiullah MR. Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes. World J Urol. 2013;31(3):573–8.
8. Ribera MC, Pascual R, Orozco D, Pérez Barba C, Pedrera V, Gil V. Incidence and risk factors associated with urinary tract infection in diabetic patients with and without asymptomatic bacteriuria. Eur J Clin Microbiol Infect Dis. 2006;25(6):389–93.
9. Funfstuck R, Nicolle LE, Hanefeld M, Naber KG. Urinary tract infection in patients with diabetes mellitus. Clin Nephrol. 2012;77:40–8.
10. Nicolle LE. Urinary tract infection in diabetes. Curr Opin Infect Dis. 2005;18:49–53.
11. Stapleton A (2002). Urinary tract infections in patients with diabetes. Am. J. Med. 113(1): 805-845.
12. Olaitan JO (2006). Asymptomatic bacteriuria in female student’s population of a Nigeria University. Int. J. Microbiol. 2(2): 4-9.
13. Ghenghesh KS, Elkateb E, Berbash N, Abdel Nada R, Ahmed SF, Rahouma A, et al. Uropathogens from diabetic patients in Libya: virulence factors and phylogenetic groups of Escherichia coli isolates. J Med Microbiol. 2009;58(8):1006–14.
14. Hamdan HZ, Ziad AH, Ali SK, Adam I. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital. Ann Clin Microbiol Antimicrob. 2011;18(10):2.
15. Lakhan Singh, Ramanesh Murthy, Hemlata Singh, Prashant Nigam. Asymptomatic Bacteriuria In Patients With Type-2 Diabetes Mellitus. NJIRM 2013; 4(6) : 1-4.
16. Ertugrul Guclu,Tuba Damar,Oguz Karabay.The number of urine specimens for bacteriological examination in women.African Health Sciences 2014; 14 (2):489.
17. Mendoza T, García de los Ríos M, Lafourcade M, Soto C, Durruty P, Alvo M. Asymptomatic bacteriuria in type 2 diabetics women. Rev Med Chil. 2002 Sep;130(9):1001-7.
18. Wayne PA. Clinical and Laboratory Standards, Performance standards for antimicrobial disk susceptibility tests. Approved standard. Clinical and Laboratory Standards Institute 2014; Document M100-S 24.
19. Akoachere JFT, Suylika Y, Njom HA, Esemu NS. Etiologic profile and antimicrobial susceptibility of community-acquired urinary tract infection in twoCameroonian towns. BMC Research notes 2012; 5: 219.
20. Yuyun MF, Angwafo III FF, Koulla-Shiro S,Zoung-Kanyi J. Urinary tract infections and genitourinary abnormalities in Cameroonian men. Trop Med Int Health 2004; 9 (4): 520-525.
21. Alebiosu CO, Osinupebi OA, Olajubu FA.Significant asymptomatic bacteriuria amongN igerian type 2 diabetics. J Natl Med Assoc 2003;95: 344-351.
22. Lyamuya EF, Moyo SJ, Komba EV, Haule M.Prevalence, antimicrobial resistance and associated risk factors for bacteriuria in diabetic women in Dar es Salaam, Tanzania. Afr J Microbiol Res 2011; 5 (6): 683-689.
23. Odetoyin WB, Aboderin AO, Ikem RT, Kolawole BA, Oyelese AO. Asymptomatic bacteriuria in patients with diabetes mellitus in Ile-Ife, South-West, Nigeria. East Afr Med J 2008; 85:18-23.
24. Wogu MD, Ogbebor NE. Prevalence of asymptomatic bacteriuria in secondary school students in Benin City. Afr Res Rev 2011; 5 (4): 145-151.
25. Yeshitela B, Gebre-Selassie S, Feleke Y. Asymptomatic bacteriuria and symptomatic urinary tract infections (UTI) in patients with diabetes mellitus in Tikur Anbessa Specialized University Hospital, Addis Ababa. Ethiopia Ethiop Med J. 2012;50(3):239–49.
26. Ophori EA, Imade P, Johnny EJ. Asymptomatic bacteriuria in patients with diabetes. J Bacteriol Research 2010; 2 (2): 14-17.
27. Assel MT, Al-Meer FM, Al-Kuwari MG, Ismail MF. Prevalence and predictor of asymptomatic bacteriuria among pregnant women attending Primary health care in Qatar Middle East J Fam Med 2009; 4:14-17.
28. Hirji I, Guo Z, Andersson SW, Hammar N, Gomez-Caminero A. Incidence of urinary tract infection among patients with type 2 diabetes in the UK General Practice Research Database (GPRD). J Diabetes Complications. 2012;26(6):513–6.
29. Guillausseau PJ, Farah R, Laloi-Michelin M, Tielmans A, Rymer R, Warnet A.Urinary tract infections and diabetes mellitus. Rev Prat. 2003;53(16):1790–6.
30. Geerlings SE. Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment. Int J Antimicrob Agents. 2008;31 Suppl 1:S54–7.
31. Muller LM, Gorter KJ, Hak E, Goudzwaard WL, Schellevis FG, Hoepelman AI, et al. Increased risk
of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis. 2005;41:281–8.
32. Valerius NH, Eff C, Hansen NE, Karle H, Nerup J, Soeberg B, et al. Neutrophil and lymphocyte function in patients with diabetes mellitus. Acta Med Scand. 1982;211:463–7.
33. Hoepelman AI, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicrob Agents. 2003;22 Suppl 2:35–43.
34. Kayima JK, Otieno LS, Twahir A, Njenga E. Asymptomatic bacteriuria among diabetics attending Kenyatta National Hospital. East Afr Med J. 1996;73(8):524–6.
35. Simkhada R. Urinary tract infection and antibiotic sensitivity pattern among diabetics. Nepal Med Coll J. 2013;15(1):1–4.
36. Omoregie R, Erebor JO, Ahonkhai I, Isibor JO, Ogofere H. Observed changes in the prevalence of uropathogens in Benin City, Nigeria. Nz J Med Lab Science 2008; 29-31.
37. Al-Attas SA, Amro SO. Candidal colonization, strain diversity and antifungal susceptibility among adult diabetic patients. Annals of Saudi Medicine 2010; 30 (2): 101–108.
38. Li XZ, Livermore DM Nikaido H. Role of efflux pump(s) in intrinsic resistance of Pseudomonas aeruginosa resistance to tetracycline, chloramphenicol, and norfloxacin. Antimicrobial Agents and Chemotherapy 1994; 38: 1732–1741
39. Gangoue PJ, Koulla SS, Ngassam P, Adiogo D, Ndumbe P. Antimicrobial activity against Gram negative bacilli from Yaounde Central Hospital, Cameroon. African Health Sciences 2006; 6 (4): 232-235.

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Published

2018-02-02

How to Cite

Kulkarni, K. V., Niranjan, N., & Talele, J. (2018). Study of Asymptomatic Bacteriuria in Type 2 Diabetes Mellitus Patients: Study of Asymptomatic Bacteriuria in Type 2 Diabetes Mellitus Patients. National Journal of Integrated Research in Medicine, 8(3), 12–16. https://doi.org/10.70284/njirm.v8i3.1236

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