Gizachew Yismaw, Daniel Asrat, Yimtubezinash Woldeamanuel, Chandrashekhar G. Unakal
A prospective cross sectional study was conducted to determine the causative agents of UTI in asymptomatic and symptomatic diabetic patients, associated risk factors and drug resistance pattern of the isolates. Between May and June 2010, a total of 422 diabetic patients with asymptomatic UTI (n=387) and symptomatic UTI (n=35) were investigated for urinary tract infection at Gondar University Hospital. Clean catch mid-stream urine specimens were collected from each study subjects. Urine culture, identification and sensitivity tests were done using standard microbiologic procedure. The age range of study participants was 20 to 84 years (mean age 42.3 years). Significant bacteriuria was detected in 14.7% and 51.4% of asymptomatic and symptomatic diabetic patients, respectively. The overall prevalence of significant bacteriuria in both groups was 17.8%. A total of 82 different bacterial uropathogens were isolated. Out of the 82 bacterial isolates, E. coli (31.7%), coagulase negative staphylococci (CONs) (22%), Klebsiella spp. (14.6%), Enterococcus spp. (11%) and S. aureus (8.5%) were the commonest bacterial uropathogens in both groups. The gram positive and negative bacteria accounted for 42.7% and 57.3% of the bacteria isolates, respectively. Significant bacteriuria was significantly associated with history of previous UTI, antibiotic treatment, type of diabetes and blood glucose level. Both gram positive and negative bacteria showed significant level of resistance to most antimicrobial agents tested. Multidrug resistance to two or more drugs was observed in 59.8% of bacterial isolates.
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