Mirza Sain Ziaullah, Rafeeq Misbahuddin, Sayed Murad Hussam Aly, Hussain Muhammad Barkaat
Department of Microbiology, Faculty of Medicine, Rabigh campus, King Abdulaziz University, Saudi Arabia, 21589.
Department of Pharmacology, Faculty of Medicine, Rabigh campus, King Abdulaziz University, Saudi Arabia, 21589.
Bioinformation. 2022 Aug 31;18(8):710-717. doi: 10.6026/97320630018710. eCollection 2022.
Urinary tract infection (UTI), contribute substantially to healthcare burden. Diabetes predispose to UTI with high glycosuria being fertile medium for bacterial growth. With changing bacterial drug resistance patterns; the problem needs to be studied periodically to ensure a rational therapy, minimize adverse effects, and cost. Therefore, it is of interest to compare the profile and susceptibility pattern of uropathogens isolated from diabetic and non-diabetic patients with UTI. Mid-stream urine samples of 1100 patients (diabetic and non-diabetic), presenting with UTI symptoms were aseptically collected and inoculated into CLED medium. Colony counts of 105cfu/ml or 104cfu/ml and >5 pus cells per high power microscopic field were regarded as significant bacteriuria. Colonies from CLED were sub-cultured onto sheep blood agar and MacConkey agar. Bacterial identification was performed on the basis of colony morphology, gram staining, and series of biochemical tests though Analytical Profile Index (API) test strips. Drug susceptibility was done by standard Kirby-Bauer disk diffusion. Data was analyzed by SPSS ver. 25.Clinically significant bacteriuria was 32.8% and 19.2% in diabetics and non-diabetics respectively. The frequency of male and female patients was 153 and 208 in diabetic group; and 69 and 142 respectively in non-diabetic group. Diabetics were twice at risk of UTI; [Odds ratio; 2.04 (CI: 1.68-2.48, p<0.05)]. .Escherichia coli and klebsiella were most common gram-negative, while Staphylococcus aureus and Coagulase-negative staphylococci (CoNS) were most common gram-positive bacteria in both the groups. Most effective antibiotics against gram-negative bacteria were carbapenems, amikacin, colistin, and piperacillin/tazobactam; while ampicillin/amoxicillin, fluoroquinolones and cephalexin were least effective. For gram-positives, vancomycin, linezolid and tigecycline were most effective. No significant difference in bacterial profile and susceptibility pattern was found between diabetics and non-diabetics. However, diabetics were twice at risk of UTI compared to non-diabetics.
尿路感染（UTI）给医疗保健带来了沉重负担。糖尿病易引发UTI，高糖尿症为细菌生长提供了肥沃的培养基。随着细菌耐药模式的变化，需要定期研究这个问题，以确保合理治疗，将不良反应和成本降至最低。因此，比较从患有UTI的糖尿病患者和非糖尿病患者中分离出的尿路病原体的特征和药敏模式很有意义。对1100例出现UTI症状的患者（糖尿病患者和非糖尿病患者）的中段尿样本进行无菌采集，并接种到CLED培养基中。菌落计数为105cfu/ml或104cfu/ml且每高倍显微镜视野中有超过5个脓细胞被视为显著菌尿。从CLED培养基上的菌落进行亚培养到羊血琼脂和麦康凯琼脂上。通过菌落形态、革兰氏染色以及通过分析谱指数（API）测试条进行的一系列生化试验来进行细菌鉴定。药敏试验采用标准的 Kirby-Bauer 纸片扩散法。数据用SPSS 25版软件进行分析。糖尿病患者和非糖尿病患者中临床上显著菌尿的发生率分别为32.8%和19.2%。糖尿病组男性和女性患者的人数分别为153人和208人；非糖尿病组分别为69人和142人。糖尿病患者患UTI的风险是正常人的两倍；[比值比；2.04（95%置信区间：1.68 - 2.48，p<0.05）]。大肠杆菌和克雷伯菌是最常见的革兰氏阴性菌，而金黄色葡萄球菌和凝固酶阴性葡萄球菌（CoNS）是两组中最常见的革兰氏阳性菌。针对革兰氏阴性菌最有效的抗生素是碳青霉烯类、阿米卡星、黏菌素和哌拉西林/他唑巴坦；而氨苄西林/阿莫西林、氟喹诺酮类和头孢氨苄效果最差。对于革兰氏阳性菌，万古霉素、利奈唑胺和替加环素最有效。糖尿病患者和非糖尿病患者在细菌特征和药敏模式上没有显著差异。然而，糖尿病患者患UTI的风险是非糖尿病患者的两倍。
