Abstract

Dr. Muhammad Wajid Rasool*, Dr. Urva Shahid and Dr. Rida Rana

ABSTRACT

Aim of study: The prevalence of asymptomatic and symptomatic UTI is very high among diabetic patients. This study was conducted to assess the frequency of microorganism involved in urinary tract infection among diabetic patients. Methodology: It is cross-sectional study done at Pathology department and Diabetic OPD of Nishtar Hospital Multan for a period of 6 months from December 2018 to April 2019. Total 250 samples of Urine was collected from patients visiting diabetic OPD. Patients having symptoms of UTI or having more than 5 WBC/HPF on urine analysis were selected for the study and urine culture was performed on their samples. Using a standard quantitative loop, urine samples (1 ?L and 10 ?L) were used to inoculate Cysteine lactose electrolyte deficient (CLED) agar (Oxoid, Basingstoke, UK), MacConkey, 5% Sheep Blood agar, and chromogenic UTI (Oxoid) agar plates. Plates were incubated for 24 h at 37°C and the outcome was judged as significant/nonsignificant growth, or contaminated (discarded). Significant bacteriuria was defined as urine culture plates showing ?105 colony-forming units (CFU)/mL of single bacterial species. Results: Total 250 urine samples of diabetic patients were selected for study. Among these patients 162 (64.8%) were female and 88 (35.2%) were males. 171 (68.4%) patients were having symptoms of urinary tract infection and remaining 79 (31.6%) were asymptomatic. Asymptomatic patients were having more than 5 WBC/HPF on complete urine analysis. 31 patients were having HbA1c with in target range (i.e. 6-7), 100 patients were having HbA1c 7-8 and remaining 119 patients were having HbA1c above 8. After 24 hours of intubation in the required media we found 20 sample were having mixed growth/contaminated, 195 (78%) sample were having E.coli growth, in 64 (25.6%) patients were Klebsiella spp, Staphylococcus in 31 (12.4%), Pseudomonas in 15 (6%), Proteus in 9 (3.6%), Streptococcus in 2 (0.8%), Enterococcus spp. in 3 (1.2%) and Candida spp. in 1 (0.4%). Conclusion: UTIs are frequent in patients with diabetes. The most frequent microorganism is E. coli and fungal infections are least common in diabetic patients in our study. Symptomatic UTI are more common in patients due to late presentation to hospital. Among asymptomatic UTI cases, female were more common as compared to male.