Diabetes Mellitus and Lower Urinary Tract Infection Management in a Single Tertiary Center

Objective: Diabetes mellitus (DM) is known to increase urinary tract infections. Due to the frequent use of antibiotics, periodic evaluations of urinary tract infection agents and antibiotic resistance in centers are crucial. The purpose of this study was to examine the distribution of bacteria isolated as lower urinary tract infection agents and the antibiotic resistance rates of these pathogens.

Methods: The records of 267 patients with a diagnosis of DM and a suspected of lower urinary tract infection who were hospitalized in the Gaziantep University Hospital Endocrinology Clinic between December 2019 and April 2022 were reviewed retrospectively. Urine and blood samples of the patients were analyzed.

Results: Of these patients, 236 (88.4%) were female. The mean age of the patients was 57.6 years, and the mean Hba1c was 10.6%. While 174 (65.16%) cultures did not grow. 80 (29.96%) bacteria and 13 (4.86%) fungi were detected in urine culture results.Twelve different bacterial species were grown in the cultures. Escherichia coli was the most frequently isolated bacterium from gram-negative bacte- ria. Streptococcus agalactiae was the most common gram-positive bacteria. There were 249 patients with pyuria and, 18 patients without pyuria. While 66 (26%) of the patients with pyuria had bacterial growth in the culture, 14 (77.7%) of the patients without pyuria had bacterial growth. There were 176 patients with glucosuria. Bacterial growth was observed in 56 (31.8%) of these patients’ pyuria was also present in 47 patients. Bacterial growth occurred in 24 (26.4%) of 91 patients without glucosuria. In gram-negative bacteria culture, ampicillin resistance was observed in 88%. Antibiotic sensitivity were positive for colistin, meropenem, and amikacin (100%, 96%, and 94%) respectively).

Conclusions: Urinary tract infections are becoming more important in diabetic patients due to their frequent recurrence and increased antibiotic resistance in isolated bacteria. Cultures take at least two days to result, necessitating the initiation of empirical antibiotic therapy. We think that each center should regularly monitor the agent distribution and antibiotic resistance status in order to select the antibiotic that can be used in empirical treatment correctly.

Cite this article as: Arslan Cellat EG, Sayıner ZA, Gümüşburun E, Akarsu E. Diabetes mellitus and lower urinary tract infection management in a single tertiary center. Endocrinol Res Pract. 2023;27(3):154-157.