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巴基斯坦一家三级医疗中心针对糖尿病合并尿路感染患者的住院情况及抗菌药物耐药模式:一项横断面研究

Hospital Admissions and Antimicrobial Resistance Patterns in Diabetic Patients With Urinary Tract Infections: A Cross-Sectional Study From a Tertiary Care Center in Pakistan.

作者信息

Raza Ali, Pervaiz Numan, Ali Irfan, Shafqat Mariam Bint, Zubair Muhammad, Memon Misbah Shirin, Shaikh Abdullah, Ramzan Hafiza Sobia

机构信息

Department of Medicine, Gulab Devi Teaching Hospital, Lahore, PAK.

Department of Medicine, Farooq Hospital, Lahore, PAK.

出版信息

Cureus. 2025 Aug 5;17(8):e89432. doi: 10.7759/cureus.89432. eCollection 2025 Aug.

Abstract

Background Diabetes mellitus is a global public health challenge, significantly increasing susceptibility to infections, particularly urinary tract infections (UTIs). Diabetic patients face a higher risk of recurrent and complicated UTIs due to impaired immune function, poor glycemic control, and associated comorbidities. Objective This study aimed to determine the frequency and demographic trends of hospital admissions in diabetic patients suffering from urinary tract infections, identify associated clinical risk factors, evaluate the microbiological profile of uropathogens, and assess prevailing patterns of antimicrobial resistance. Methodology This cross-sectional study was conducted at Gulab Devi Hospital, Lahore, from 1st January 2025 to 30th June 2025. A total of 325 diabetic patients admitted with suspected UTIs were included using non-probability consecutive sampling. Demographic, clinical, and laboratory data were collected. Midstream urine samples were cultured to identify pathogens, and antimicrobial susceptibility was tested using the disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results Among 325 participants, 205 patients (63.1%) had culture-confirmed UTIs. The mean age of UTI-positive patients was 59.2 ± 9.8 years, significantly higher than non-UTI patients (55.8 ± 11.3 years; p = 0.01). Age over 60 years was present in 129 (62.9%) UTI cases. Poor glycemic control (HbA1c >8%) was found in 162 (79.0%) UTI patients, and 152 (74.1%) had diabetes duration exceeding 10 years. Hypertension was reported in 148 (72.2%) and diabetic nephropathy in 67 (32.7%) UTI patients. was the predominant pathogen in 117 (57.1%) cases, followed by in 37 (18.0%) cases. High resistance rates were seen for amoxicillin in 154 (75.1%) and cotrimoxazole in 139 (67.8%) isolates, while nitrofurantoin and ceftriaxone demonstrated high sensitivity in 174 (84.9%) and 166 (81.0%) cases, respectively. Conclusion It is concluded that urinary tract infections are a common and serious cause of hospital admissions in diabetic patients, particularly those with advanced age, poor glycemic control, and long-standing diabetes. remains the predominant pathogen with evolving antimicrobial resistance trends.

摘要

背景 糖尿病是一项全球性的公共卫生挑战,显著增加了感染易感性,尤其是尿路感染(UTIs)。糖尿病患者由于免疫功能受损、血糖控制不佳及相关合并症,面临复发性和复杂性尿路感染的更高风险。目的 本研究旨在确定患有尿路感染的糖尿病患者的住院频率和人口统计学趋势,识别相关临床危险因素,评估尿路病原体的微生物学特征,并评估主要的抗菌药物耐药模式。方法 本横断面研究于2025年1月1日至2025年6月30日在拉合尔的古拉布·德维医院进行。采用非概率连续抽样纳入了325例疑似尿路感染的糖尿病住院患者。收集了人口统计学、临床和实验室数据。对中段尿样本进行培养以鉴定病原体,并根据临床和实验室标准协会(CLSI)指南采用纸片扩散法检测抗菌药物敏感性。结果 在325名参与者中,205例患者(63.1%)尿培养确诊为尿路感染。尿路感染阳性患者的平均年龄为59.2±9.8岁,显著高于非尿路感染患者(55.8±11.3岁;p=0.01)。129例(62.9%)尿路感染病例患者年龄超过60岁。162例(约79.0%)尿路感染患者血糖控制不佳(糖化血红蛋白>8%),152例(74.1%)糖尿病病程超过10年。148例(72.2%)尿路感染患者报告有高血压,67例(32.7%)有糖尿病肾病。117例(57.1%)病例中 是主要病原体,其次是37例(18.0%)病例中的 。154株(75.1%)分离株对阿莫西林耐药率高,139株(67.8%)对复方新诺明耐药率高,而呋喃妥因和头孢曲松分别在174例(84.9%)和166例(81.0%)病例中显示出高敏感性。结论 得出结论,尿路感染是糖尿病患者住院的常见且严重原因,尤其是老年、血糖控制不佳和糖尿病病程长的患者。 仍然是主要病原体,且抗菌药物耐药趋势不断演变。 (注:原文中部分病原体名称未完整给出,翻译时保留原文形式)

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