Salem Mona A, Matter Randa M, Abdelmaksoud Abeer A, El Masry Sherin A
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
J Egypt Soc Parasitol. 2009 Dec;39(3):951-62.
The prevalence of asymptomatic bacteriuria (ASB) and associated risk factors were investigated in 100 Egyptian children and adolescents with type 1 diabetes mellitus and 100 age and sex matched healthy controls. All were subjected to clinical evaluation and assessment of mean random blood glucose, mean glycosylated hemoglobin (HbA1c); microalbuminuria and midstream urinary samples were collected for complete urine analysis and two consecutive urine cultures and sensitivity tests. The prevalence of ASB was higher among diabetics than controls (30% versus 14%, p < 0.01) and was more among older age (p = 0.033) and female patients (p < 0.001); especially postpubertal. Microalbuminuria (36.7%) and microvascular complications (50%) were significant risk factors for ASB in patients while metabolic control and disease duration were not relevant to ASB (p > 0.05). Pyuria was a strong predictor of bacteriuria in patients (80%) and controls (100%). The most common isolates were E. coli in patients (30%) and Pseudomonas in controls (57.1%). Gram positive isolates were detected in 46.7% of diabetic patients but not in controls. ASB is more prevalent among type 1 diabetic patients in the pediatric age group. Screening for ASB is warranted in diabetic patients with risk factors especially if pyuria is detected in their urine analysis.
对100名埃及1型糖尿病儿童及青少年以及100名年龄和性别匹配的健康对照者进行了无症状菌尿（ASB）患病率及相关危险因素的调查。所有人均接受了临床评估以及平均随机血糖、平均糖化血红蛋白（HbA1c）的测定；收集了微量白蛋白尿和中段尿样本用于完整尿液分析以及连续两次尿培养和药敏试验。糖尿病患者中ASB的患病率高于对照组（30%对14%，p<0.01），且在年龄较大者（p=0.033）和女性患者（p<0.001）中更为常见；尤其是青春期后。微量白蛋白尿（36.7%）和微血管并发症（50%）是患者ASB的显著危险因素，而代谢控制和病程与ASB无关（p>0.05）。脓尿是患者（80%）和对照组（100%）菌尿的有力预测指标。最常见的分离菌在患者中为大肠杆菌（30%），在对照组中为假单胞菌（57.1%）。46.7%的糖尿病患者检测到革兰氏阳性菌分离株，而对照组未检测到。ASB在儿童年龄组的1型糖尿病患者中更为普遍。对于有危险因素的糖尿病患者，尤其是尿液分析中检测到脓尿的患者，有必要进行ASB筛查。
