Abstract:
Background: Urinary tract infections (UTIs) are more commonly encountered in diabetes
mellitus (DM) patients. Prevalence of asymptomatic bacteriuria is more common compared to
symptomatic bacteriuria in DM patients. Determination of causative pathogens and
pathophysiological parameters associated with UTI in DM patients in Sri Lanka is invaluable to
promote their health.
Objectives: To identify pathogens causing UTIs in DM patients together with their antibiotic
susceptibility patterns and to determine association of certain pathophysiological parameters to
UTI in DM patients.
Methods: A cross-sectional study was conducted among 60 DM patients attending to diabetic
clinic, Teaching Hospital Karapitiya. Demographic data; age, gender, marital status, and
pathological data; duration of diabetes, glycaemic control and type of treatment were collected
using a questionnaire. Patients were instructed to collect clean-catch, mid-stream urine samples
into provided sterile containers. Urine samples were cultured and processed according to the
guidelines of Clinical and Laboratory Standards Institute. Antibiotic susceptibility test was
performed using disc diffusion method. All the data were analysed using SPSS version 15.0.
Results: There were 7 (11.67%) positive urine cultures out of 60 samples. They all were pure
growths with colony count >99. Among them 10% of the patients were asymptomatic and only
1.67% were symptomatic. There were no significant associations between diabetic UTI and
each parameter of age range (p=0.870), gender (p=0.402), marital status (p=0.518), type of
diabetic treatment (p=0.601) and glycaemic control (p=0.325). However, a significant
relationship was found between duration of DM and diabetic UTI (p=0.001). Escherichia coli
(E. coli) was the most frequent isolated pathogen (85.71%) followed by Candida spp. (14.29%).
All the E. coli strains showed similar antibiotic susceptibility pattern. They all were sensitive to
nitrofurantoin, amikacin, gentamycin and meropenem but resistant to cefuroxime.
Conclusions: Prevalence of asymptomatic bacteriuria is more common among patients with
DM. Longer duration of diabetes for >5 years is found as a risk factor of UTI. E. coli is the most
common pathogen among the diabetic patients having UTI.
