Iddrisu Abdul-Karim, Owusu George, Doe Samuel Kofi, Yeboah Augustine Apraku, Agyapong Joseph, Yankey Nicholas
Department of Mathematics and Statistics University of Energy and Natural Resources Sunyani Ghana.
Department of Medical Laboratory Science University of Energy and Natural Resources Sunyani Ghana.
Health Sci Rep. 2024 Sep 18;7(9):e70072. doi: 10.1002/hsr2.70072. eCollection 2024 Sep.
Uropathogens are microorganisms that cause urinary tract infections (UTIs). Owing to higher blood glucose levels and compromised immune functions, treatment of uropathogens in diabetic patients is a challenge.
This study aims to assess the prevalence of uropathogens and their antibiotic susceptibility among diabetic patients at St. John of God Hospital at Duayaw Nkwanta (SJGHDN) in the Ahafo region of Ghana.
The cross-sectional study recruited 175 diabetic patients at SJGHDN between August and September 2023. Questionnaires were used to collect patients' background information. Fasting Blood Sugar (FBS) was assessed by using a glucometer. Urine samples were examined for the presence of uropathogens. A sterile inoculating loop with a calibrated volume of 2 µl was used for plating. Each colony equals 500 CFU/mL. Significant uropathogen was determined by multiplying the counted colonies by 500 to obtain CFU/mL. Positive uropathogen was defined as CFU ≥ 10/mL. Significant uropathogen was defined as ≥200 colonies per sample. The disc diffusion method was used to determine antibiotic susceptibility.
Out of the 175 patients, 19.4% expressed various uropathogens with being the predominant. Suboptimal glucose level was the most significant risk factor ( = 0.038). Glucosuria ( = 0.036), hazy urine ( = 0.028), positive leukocyte esterase ( = 0.001), and pus cells in urine sediment ( = 0.020) were significant indicators of uropathogen occurrence. and were resistant to ≥4 antibiotics. Amikacin, nitrofurantoin, levofloxacin, ciprofloxacin, and ceftriaxone demonstrated efficacy against the isolates.
This study underscores the notable prevalence of uropathogens in diabetic patients and the alarming levels of antibiotic resistance observed. The results highlight the critical need for vigilant monitoring and customized treatment approaches, particularly for diabetic patients exhibiting risk factors such as elevated urine glucose levels, cloudy urine, and presence of leukocyte esterase and pus cells in urine sediment. The significant resistance to frequently used antibiotics like co-trimoxazole and tetracycline points to the necessity of routine susceptibility testing and the use of alternative antibiotics for effective treatment. These findings can assist healthcare providers in more effectively managing and preventing UTIs in diabetic populations.
尿路病原体是引起尿路感染（UTIs）的微生物。由于血糖水平较高和免疫功能受损，糖尿病患者中尿路病原体的治疗具有挑战性。
本研究旨在评估加纳阿哈福地区杜阿亚瓦恩夸塔圣若翰医院（SJGHDN）糖尿病患者中尿路病原体的流行情况及其抗生素敏感性。
这项横断面研究于2023年8月至9月在SJGHDN招募了175名糖尿病患者。使用问卷调查收集患者的背景信息。使用血糖仪评估空腹血糖（FBS）。检查尿液样本中是否存在尿路病原体。使用校准体积为2μl的无菌接种环进行接种。每个菌落等于500CFU/mL。通过将计数的菌落数乘以500以获得CFU/mL来确定显著尿路病原体。阳性尿路病原体定义为CFU≥10/mL。显著尿路病原体定义为每个样本≥200个菌落。采用纸片扩散法测定抗生素敏感性。
在175名患者中，19.4%的患者检出各种尿路病原体，其中[某种病原体]最为常见。血糖水平未达最佳状态是最显著的危险因素（P = 0.038）。糖尿（P = 0.036）、尿液浑浊（P = 0.028）、白细胞酯酶阳性（P = 0.001）和尿沉渣中的脓细胞（P = 0.020）是尿路病原体发生的显著指标。[某种病原体]和[另一种病原体]对≥4种抗生素耐药。阿米卡星、呋喃妥因、左氧氟沙星、环丙沙星和头孢曲松对分离株显示出疗效。
本研究强调了糖尿病患者中尿路病原体的显著流行以及观察到的抗生素耐药性的惊人水平。结果突出了对糖尿病患者进行密切监测和定制治疗方法的迫切需求，特别是对于那些表现出如尿糖水平升高、尿液浑浊以及尿沉渣中存在白细胞酯酶和脓细胞等危险因素的患者。对复方新诺明和四环素等常用抗生素的显著耐药性表明有必要进行常规药敏试验并使用替代抗生素进行有效治疗。这些发现可帮助医疗保健提供者更有效地管理和预防糖尿病患者的尿路感染。
