Yeshitela Biruk, Gebre-Selassie Solomon, Feleke Yeweyenhareg
Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Science, Addis Ababa University.
Ethiop Med J. 2012 Jul;50(3):239-49.
The risk of urinary tract infection in diabetic patients is higher and the etiology and the antibiotic resistance of uropathogens have been changing over the past years.
The aim of this study was to determine the prevalence of symptomatic and asymptomatic bacteriuria and assess the antimicrobial susceptibility pattern of the isolates in diabetic patients.
A prospective study was conducted during June to August 2009 on diabetic in and out-patients in Tikur Anbessa University Hospital. A total of 413 consented adult patients were enrolled in the study. Two consecutive clean-catch midstream urine samples from diabetic subjects were collected for culture. Disc diffusion method was used to assess the antimicrobial susceptibility patterns of the isolates.
Of the 413 diabetic patients participated in the study, 181 (43.8%) were males and 232 (56.2%) were females. Of these, 107 (25.9%) were type 1 and 306 (74.1%) were type 2 diabetes mellitus. Nine (13.6%) of the symptomatic diabetic patients had bacteriuria compared with 36 (10.4%) of asymptomatic diabetes patients had bacteriuria. The overall prevalence of urinary tract infection in the diabetic patients was 45 (10.9%). The predominant isolates were Escherichia coli and Klebsiella pneumoniae isolated in 6% and 28% followed by 2% and 6% in symptomatic and asymptomatic diabetic patients, respectively. Over 85% of Escherichia coli isolates were sensitive to ciprofloxacin, amoxicillin-clavulanic acid, ceftazidime, nitrofuranton, ceftiraxone, norfloxacin and geamicin. Klebsiella pneumoniae were 100% sensitive to ciprofloxacin, ceftazidime, ceftriaxone. The rate of resistance to two or more antimicrobials was 33 (71.7%).
The prevalence of urinary tract infection in this study was higher in women than in men. Escherichia coli was frequently isolated in both symptomatic and asymptomatic patients. Over 60% of the isolates were resistant to ampicillin, trimethoprim-sulphamethoxazole and tetracycline. Investigation of bacteriuria in diabetic patients for urinary tract infection is important for treatment and prevention of the development of renal complications.
糖尿病患者发生尿路感染的风险较高，且在过去几年中尿路病原体的病因及抗生素耐药性一直在变化。
本研究旨在确定糖尿病患者有症状和无症状菌尿的患病率，并评估分离菌株的抗菌药敏模式。
2009年6月至8月，对提库尔安贝萨大学医院的糖尿病门诊和住院患者进行了一项前瞻性研究。共有413名同意参与的成年患者纳入研究。收集糖尿病受试者连续两份清洁中段尿样本进行培养。采用纸片扩散法评估分离菌株的抗菌药敏模式。
参与研究的413例糖尿病患者中，男性181例（43.8%），女性232例（56.2%）。其中，1型糖尿病患者107例（25.9%），2型糖尿病患者306例（74.1%）。有症状的糖尿病患者中9例（13.6%）有菌尿，无症状糖尿病患者中有36例（10.4%）有菌尿。糖尿病患者尿路感染的总体患病率为45例（10.9%）。主要分离菌株为大肠埃希菌和肺炎克雷伯菌，在有症状和无症状糖尿病患者中分别占6%和28%，其次分别为2%和6%。超过85%的大肠埃希菌分离株对环丙沙星、阿莫西林-克拉维酸、头孢他啶、呋喃妥因、头孢曲松、诺氟沙星和庆大霉素敏感。肺炎克雷伯菌对环丙沙星、头孢他啶、头孢曲松的敏感性为100%。对两种或更多种抗菌药物耐药的比例为33例（71.7%）。
本研究中尿路感染的患病率女性高于男性。大肠埃希菌在有症状和无症状患者中均经常分离到。超过60%的分离株对氨苄西林、甲氧苄啶-磺胺甲恶唑和四环素耐药。对糖尿病患者进行菌尿调查以诊断尿路感染对于治疗和预防肾脏并发症的发生很重要。
