Prevalence of uropathogens in diabetic patients and their corresponding resistance pattern: results of a survey conducted at diagnostic centers in dhaka, bangladesh.

OBJECTIVES

Urinary tract infection is the second most common clinical indication for empirical antibiotic treatment in primary and secondary health care settings. The incidence of diabetes mellitus throughout the world is increasing strikingly and in the long run, it has some major effects on the genitourinary system which makes diabetic patients more liable to urinary tract infection. This study is designed to reveal the distribution of uropathogens in diabetic patients according to age and sex, and corresponding resistance patterns.

METHODS

A six-month retrospective review of urine culture assay data from August 2009 to January 2010 from randomly selected 85 patients who suffered from both urinary tract infection and diabetes was conducted. Relevant information was retrieved and analyzed statistically using Microsoft® Excel 2002 software.

RESULTS

The study showed that females are more vulnerable to pathogenic attack than males throughout a wide age distribution. In terms of pathogenic distribution, Escherichia coli was the highest followed by Streptococcus sp., Acinetobacter, Klebsiella pneumoniae and few others. Though Meropenem showed no resistance with E. coli, Acinetobacter and Klebsiella pneumoniae, in the case of Streptococcus sp. it exhibited resistance of 25%. Amikacin exhibited only 3% resistance with E. coli, whereas no resistance with Acinetobacter and Klebsiella pneumoniae, and most interestingly showed 75% resistance with Streptococcus sp. Gentamicin exhibited no resistance with Acinetobacter while 26.9%, 50% and 87.5% resistance with E. coli, Klebsiella pneumoniae and Streptococcus sp. respectively. Hence, Nitrofurantoin exhibited less resistance 11.9% compared to 12.5% resistance with E. coli and Streptococcus sp. Nitrofurantoin was highly prone to resistance with Acinetobacter and Klebsiella pneumoniae (100%, 50% respectively). Cephalosporins (cephradine, cefixime, ceftriaxone, cefepime etc.) showed moderate resistance (avg. 50%), whereas amoxicillin and ciprofloxacin showed the highest resistance in all these cases.

CONCLUSION

Pathogens are mostly resistant to antibiotics including amoxicillin, ciprofloxacin, cephalosporins and nitrofurantoin, with few exceptions including gentamicin, amikacin and meropenem.