Urinary tract infection in diabetes: Uropathogens, relatedfactors, and antimicrobial sensitivity at Sari, Iran

Background and Aim : : Based on the high frequency of UTI in diabetic patients andconsequently using more antibiotics, this study aimed to determine the common uropathogens indiabetic patients, etiological factors, antibiotic resistance patterns, and MIC to improve insight inthis infection, treat better, prevent inappropriate antibiotic use, and reduce community resistance.Methods : In this cross-sectional study, having common UTI symptoms and possible risk factorswere collected via the questionnaire from ۳۰۲ patients with diabetes for analyzing. The taken urinesamples were cultured for diagnosing UTI. For every positive sample, disk diffusion tests weredone. Those antibiotics with the highest rate of resistance and intermediate resistance wereselected. The E-test was then used for further examination and MIC determination.Results : Of the total ۳۰۲ samples, ۲۲.۵% were detected as UTI positive. Isolated bacteria were۵۹.۴% and ۴۰.۵۹% of the various gram-positive and negatives species, respectively. The mostpredominant bacteria were S. agalactiae (۲۵%). There is clear correlation between UTI and havingfever (p-value= ۰.۰۳۴), urgency (p-value=۰.۰۴) as symptoms and renal failure (p-value= ۰.۰۰۶),recent hospitalization (p-value= ۰.۰۱۸), and diabetes duration (p-value=۰.۰۲۸) as risk factors.Antibiogram showed that the most sensitivity to piperacillin-tazobactam (۹۶%) in gram- positivesand gentamicin (۱۰۰%) in gram-positive and negatives. Besides, the results of the E-test comparedwith disk diffusion.Conclusion : The study showed that first-line drugs commonly used in UTI are not appropriatefor diabetic patients. It seems using other antibiotics according to isolated bacteria and antibiogramtests considering for better UTI treatment among diabetic patients.

کلیدواژه ها:

Urinary tract infection (UTI) ، Diabetes Mellitus (D.M.) ، Antibiotic resistance ، Uropathogens ، Bacteriuria