Volume : X, Issue : II, February - 2020

CLINICAL SPECTRUM OF URINARY TRACT INFECTION IN DIABETICS AND NON DIABETICS

Dr. Lakshminarayana Udduru, Dr. P. Nagarjuna Reddy, Dr. G. Vijaya Kumar

Abstract :

Background: Diabetics are more prone for infections than their non diabetic counterparts. Susceptibility increases with longer duration and greater severity of Diabetes. Urinary tract infection (UTI) is the most important and most common form of infection in diabetic patients. Diabetic patients have been found to have five fold frequency of acute pyelonephritis at autopsy than non diabetics.1 Most of the urinary tract infections in patients diabetes are relatively asymptomatic. This asymptomatic infection can leads to severe kidney damage and cause renal failure. Some of the microorganisms become more virulent in a high glucose environment. Another mechanism which can increase the prevalence of infections in diabetic patients is an increased adherence of microorganisms to diabetic compared to nondiabetic cells.8 Aim: To investigate Clinical spectrum of urinary tract infection (UTI) between diabetic and non diabetic patients. Materials and Methods: A Hospital–based Prospective study was conducted in the Department of Medicine, on Patients who visit Santhiram Medical College and General Hospital in Out Patient Department and those patients who are admitted as Inpatients for a 5 months period. Universal Sampling Technique was used for the selection of study subjects. Detailed history regarding the symptoms and signs of Urinary tract infection and history of Diabetes mellitus was taken. 120 diabetics (65 females and 55 males) and 80 non–diabetics (49 females and 31 males) admitted in Santhiram Hospital were studied randomly. All proven diabetics with postprandial (2 hr) venous glucose >200 mg/dl and fasting venous glucose > 126 mg/dl were included in the study irrespective of reason for admission. All patients with a history of diabetes and those who are on treatment were also eligible for admission. Results: Fever was found to be present in diabetic and non diabetic subjects and was significantly associated with the presence of UTI. The majority of the diabetics with UTI (81.6 per cent) had glycosylated haemoglobin (HbA1c) > 6.5 per cent with p < 0.02. More than 50% of patients with recurrent UTI had glycosylated Hb ≥8.0.The isolation rate of Escherichia coli (E. coli) from urine culture was higher (62.5 per cent) among diabetic patients followed by Klebsiella (12per cent) and Enterococcus (10 per cent). Conclusion: The factors of host found to be associated with UTI are female sex, presence of fever, presence of diabetes, poor glycemic control, and past history of UTI. No correlation was noted with age. An elevated glycosylated Hb correlates with occurrence of UTI. The number of patients with UTI who had Glyco Hb below 6.5% were very small in the presence or absence of predisposing factors. A Glyco Hb >8.0% is unacceptable in patients with diabetes mellitus as it increases the chance of developing UTI and its recurrence. Escherichia coli was the most frequent uropathogen responsible for UTI and recurrent UTI in both diabetics and non–diabetics. Klebsiella and Enterococcus were the other common organisms

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Article: Download PDF    DOI : 10.36106/ijar  

Cite This Article:

CLINICAL SPECTRUM OF URINARY TRACT INFECTION IN DIABETICS AND NON DIABETICS, Dr.Lakshminarayana Udduru, Dr. P. Nagarjuna Reddy, Dr. G.Vijaya Kumar INDIAN JOURNAL OF APPLIED RESEARCH : Volume-10 | Issue-2 | February-2020

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