He Ke, Hu Yun, Shi Jun-Cheng, Zhu Yun-Qing, Mao Xiao-Ming
Department of Endocrinology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, China.
Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Ther Clin Risk Manag. 2018 Feb 26;14:403-408. doi: 10.2147/TCRM.S147078. eCollection 2018.
Urinary tract infections (UTIs) occur more frequently in diabetic patients. This study was conducted to investigate the prevalence, risk factors and microorganisms of UTIs in Chinese patients with type 2 diabetes (T2D).
A total of 3,652 Chinese inpatients with T2D were reviewed and data on their clinical characteristics, symptoms of UTIs, random blood glucose, HbA1c, glutamic acid decarboxylase antibody, insulin autoantibody, albumin excretion rate in 24-hour urine, urine culture and susceptibility to antibiotics, and so on were collected. Binary logistic analysis was performed to look for risk factors of UTIs.
There were 409 (11.2%) patients suffering from UTIs. Gender, age, random blood glucose, insulin autoantibody and albumin excretion rate in 24-hour urine were the risk factors of UTIs in diabetic patients. The percentage of positive urine cultures was higher in the asymptomatic bacteriuria patients than in symptomatic patients (<0.001). The incidence of septicemia was considerable in the UTIs and asymptomatic bacteriuria groups. was the most common pathogenic microorganism isolated in diabetic patients with UTIs, and one-half of the infections were multidrug resistant. Furthermore, meropenem was the most effective antibiotic on .
We suggest that a routine urine analysis or urine culture should be conducted in patients with T2D diabetes who have the identified risk factors. The UTIs might affect the islet function or blood glucose control in patients with T2D. Before a doctor decides to prescribe antibiotics to a diabetic patient with UTIs, the drug sensitivity test should be performed.
糖尿病患者尿路感染(UTIs)的发生率更高。本研究旨在调查中国2型糖尿病(T2D)患者中UTIs的患病率、危险因素及微生物情况。
回顾了3652例中国T2D住院患者,收集其临床特征、UTIs症状、随机血糖、糖化血红蛋白(HbA1c)、谷氨酸脱羧酶抗体、胰岛素自身抗体、24小时尿白蛋白排泄率、尿培养及抗生素敏感性等数据。进行二元逻辑回归分析以寻找UTIs的危险因素。
有409例(11.2%)患者发生UTIs。性别、年龄、随机血糖、胰岛素自身抗体及24小时尿白蛋白排泄率是糖尿病患者UTIs的危险因素。无症状菌尿患者尿培养阳性率高于有症状患者(<0.001)。UTIs组和无症状菌尿组败血症发生率较高。 是UTIs糖尿病患者中分离出的最常见致病微生物,且一半的 感染为多重耐药。此外,美罗培南是对 最有效的抗生素。
我们建议对有已确定危险因素的T2D糖尿病患者进行常规尿液分析或尿培养。UTIs可能影响T2D患者的胰岛功能或血糖控制。在医生决定给UTIs糖尿病患者开抗生素之前,应进行药敏试验。