Sewify May, Nair Shinu, Warsame Samia, Murad Mohamed, Alhubail Asma, Behbehani Kazem, Al-Refaei Faisal, Tiss Ali
Clinical Services Department, Dasman Diabetes Institute, P.O. Box 1180, 15462 Kuwait, Kuwait.
Biochemistry & Molecular Biology Unit, Dasman Diabetes Institute, P.O. Box 1180, 15462 Kuwait, Kuwait.
J Diabetes Res. 2016;2016:6573215. doi: 10.1155/2016/6573215. Epub 2015 Dec 30.
Diabetic patients have higher risk of urinary tract infection (UTI). In the present study, we investigated the impact of glycemic control in diabetic patients on UTI prevalence, type of strains, and their antimicrobial drugs susceptibility. This study was conducted on urine samples from 722 adult diabetic patients from which 252 (35%) samples were positive for uropathogens. Most UTI cases occurred in the uncontrolled glycemic group (197 patients) versus 55 patients with controlled glycemia. Higher glycemic levels were measured in uncontrolled glycemia group (HbA1c = 8.3 ± 1.5 and 5.4 ± 0.4, resp., P < 0.0001). Females showed much higher prevalence of UTI than males in both glycemic groups (88.5% and 11.5%, resp., P < 0.0001). In the uncontrolled glycemia group 90.9% of the UTI cases happened at ages above 40 years and a clear correlation was obtained between patient age ranges and number of UTI cases (r = 0.94; P = 0.017), whereas in the group with controlled glycemia no trend was observed. Escherichia coli was the predominant uropathogen followed by Klebsiella pneumoniae and they were together involved in 76.2% of UTI cases. Those species were similarly present in both diabetic groups and displayed comparable antibiotic resistance pattern. These results highlight the importance of controlling glycemia in diabetic patients to reduce the UTI regardless of age and gender.
糖尿病患者发生尿路感染（UTI）的风险更高。在本研究中，我们调查了糖尿病患者血糖控制对UTI患病率、菌株类型及其对抗菌药物敏感性的影响。本研究对722例成年糖尿病患者的尿液样本进行了检测，其中252例（35%）样本的尿路病原体呈阳性。大多数UTI病例发生在血糖控制不佳组（197例患者），而血糖控制良好组有55例患者。血糖控制不佳组的血糖水平更高（糖化血红蛋白分别为8.3±1.5和5.4±0.4，P<0.0001）。在两个血糖组中，女性UTI的患病率均明显高于男性（分别为88.5%和11.5%，P<0.0001）。在血糖控制不佳组中，90.9%的UTI病例发生在40岁以上，患者年龄范围与UTI病例数之间存在明显的相关性（r=0.94；P=0.017），而在血糖控制良好组中未观察到这种趋势。大肠杆菌是主要的尿路病原体，其次是肺炎克雷伯菌，它们共同导致了76.2%的UTI病例。这些菌种在两个糖尿病组中均有类似分布，且显示出相似的抗生素耐药模式。这些结果凸显了控制糖尿病患者血糖以降低UTI的重要性，无论年龄和性别如何。
