European Journal of Biomedical and Pharmaceutical Sciences

ASYMPTOMATIC BACTERIURIA IN PATIENTS WITH DIABETES MELLITUS AND THEIR URINE CULTURE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN IN A TERTIARY CARE LEVEL HOSPITAL – A CROSS SECTIONAL STUDY

B.Vishalakshi* and K.R.Suresh

ABSTRACT

Background: Patients with diabetes mellitus (DM) are more prone to infection, and the urinary tract is one of the most commonly affected sites. Asymptomatic bacteriuria (ASB) may progress to symptomatic urinary tract infection (UTI) in diabetics, and UTI in such patients are more likely to lead to early complications. Aim: This study attempts to estimate the prevalence of asymptomatic bacteriuria among patients with DM attending a tertiary care centre. Materials and Methods: 100 mid stream urine specimens of non catheterized patients with diabetes mellitus (not clinically diagnosed with UTI) received in Microbiology section of Central Research Laboratory during December 2008 to August 2009 were included in the study. Urine specimens were collected for microscopy, macroscopy, culture and antimicrobial susceptibility testing pattern (ASP) and extended spectrum beta lactamase (ESBL) detection. 2005 IDSA guidelines were used for the diagnosis of ASB. Samples with more than 105 CFU/mL bacteria were considered as positive. Identification and susceptibility testing was determined by using the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Out of 100 urine specimens 54 (54%) were positive for microscopy and culture. The magnitude of positivity was differed significantly between males and females with ratio of 1.8:1 (65 male and 35 female). Escherichia coli was the most frequent pathogen 21(40.38%), followed by Klebsiella pneumoniae 16(30.76%) and Acinetobacter baumannii 13(25%). Majority of gram negative uropathogens were highly resistant against ciprofloxacin, norfloxacin, sulphamethoxazole, cotrimaxozole. Conclusion: The most frequent isolate was Escherichia coli while Acinetobacter baumannii was less frequent but highly resistant. The uncertainty in clinical approach to the treatment of ASB with diabetes can be minimized by the periodic epidemiological survey of etiological agents and ASP leading to the recognition of the most frequently encountered pathogens in particular geographical area.

Keywords: Asymptomatic bacteriuria, UTI, ASP, diabetes, ESBL.