Geerlings S E, Stolk R P, Camps M J, Netten P M, Collet J T, Schneeberger P M, Hoepelman A I
Department of Internal Medicine, Division of Infectious Diseases and AIDS, Eijkman Winkler Laboratory for Medical Microbiology, University Hospital, Utrecht, F 02.126, 3508 GA Utrecht, the Netherlands.
Arch Intern Med. 2001 Jun 11;161(11):1421-7. doi: 10.1001/archinte.161.11.1421.
Women with diabetes mellitus (DM) have asymptomatic bacteriuria (ASB) more often than women without DM. It is unknown, however, what the consequences of ASB are in these women.
To compare women with DM with and without ASB for the development of symptomatic urinary tract infections (UTIs), renal function, and secondary complications of DM during an 18-month follow-up period.
In this multicenter study we monitored women with DM with and without ASB for the development of symptomatic UTIs, renal function, and secondary complications (ie, retinopathy, neuropathy, microvascular, or macrovascular diseases). Data on the first 18-month follow-up period are presented.
At least 1 uncontaminated urine culture was available from 636 women (258 with type 1 DM and 378 with type 2 DM). The prevalence of ASB at baseline was 26% (21% for those with type 1 DM and 29% for those with type 2 DM). Follow-up results were available for 589 (93%) of the 636 women. Of these 589 women, 115 (20%) (14% with type 1 DM and 23% with type 2 DM) developed a symptomatic UTI. Women with type 2 DM and ASB at baseline had an increased risk of developing a UTI during the 18-month follow-up (19% without ASB vs 34% with ASB, P =.006). In contrast, there was no difference in the incidence of symptomatic UTI between women with type 1 DM and ASB and those without ASB (12% with ASB vs 15% without ASB). However, women with type 1 DM and ASB had a tendency to have a faster decline in renal function than those without ASB (relative increase in serum creatinine level 4.6% vs 1.5%, P = 0.2).
Women with type 2 DM and ASB have an increased risk of developing a symptomatic UTI than those without ASB.
糖尿病（DM）女性比非糖尿病女性更易患无症状菌尿（ASB）。然而，ASB对这些女性的影响尚不清楚。
比较在18个月随访期内患有和未患有ASB的糖尿病女性发生有症状性尿路感染（UTI）、肾功能及糖尿病继发并发症的情况。
在这项多中心研究中，我们监测了患有和未患有ASB的糖尿病女性发生有症状性UTI、肾功能及继发并发症（即视网膜病变、神经病变、微血管或大血管疾病）的情况。本文呈现了首个18个月随访期的数据。
636名女性（258名1型糖尿病患者和378名2型糖尿病患者）至少有1次无污染的尿培养结果。基线时ASB的患病率为26%（1型糖尿病患者为21%，2型糖尿病患者为29%）。636名女性中有589名（93%）有随访结果。在这589名女性中，115名（20%）（1型糖尿病患者为14%，2型糖尿病患者为23%）发生了有症状性UTI。基线时患有2型糖尿病和ASB的女性在18个月随访期内发生UTI的风险增加（无ASB者为19%，有ASB者为34%，P = 0.006）。相比之下，患有1型糖尿病和ASB的女性与未患有ASB的女性之间有症状性UTI的发生率无差异（有ASB者为12%，无ASB者为15%）。然而，患有1型糖尿病和ASB的女性肾功能下降趋势比未患有ASB的女性更快（血清肌酐水平相对升高4.6%对1.5%，P = 0.2）。
患有2型糖尿病和ASB的女性比未患有ASB的女性发生有症状性UTI的风险增加。
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