PATTERNS OF URINARY TRACT INFECTION AMONG PATIENTS WITH DIABETES: A PROSPECTIVE TERTIARY CARE HOSPITAL SURVEY
Background: Patients with diabetes are at higher risk of acquiring urinary tract infections as compared to those without
diabetes. Urinary tract infection can present over a spectrum of asymptomatic bacteriuria to severe pyelonephritis and
urosepsis. Knowledge of the prevailing patterns is important due to the morbidity and potential mortality of this condition.
Objective: Our aim was to present a comprehensive overview of the prevailing patterns of urinary tract infection among
patients with diabetes in a tertiary care environment including patients from both outpatient and inpatient care.
Methods: This is a prospective observational study conducted at the department of Diabetes, Endocrinology and
Metabolic diseases Hayatabad Medical Complex Peshawar between July 2015 and June 2016 (12-months). All diabetic
patients who either presented with urinary tract symptomatology to the outpatient or patients who were admitted for
diabetes management were investigated for the presence of urinary tract infection (both symptomatic and asymptomatic).
Results: Of the 562 patients, there were 142 (25.3%) males and 420 (74.7%) females in a ratio of 1:2.95. The overall
mean age was 52.98 ± 8.5 years . There were 145 (25.8%) type I diabetes and 417 (74.2%) cases of type 2 diabetes.
The mean duration of diabetes was 7.7 ± 4.5 years while the mean duration of onset of urinary tract symptoms was 8.9
± 5.9 days.The dominant presenting symptom was fever in 234 (41.6%) patients, dysuria in 248 (44.1%), haematuria
in 245 (43.6%), urinary frequency in 269 (47.9%), pain abdomen in 182 (32.4%) and pyuria in 187 (33.3%) patients.
There were 174 (31.0%) patients who were asymptomatic at the time of diagnosis.
Conclusion: Females are mostly affected irrespective of the type of diabetes. Most pathogens encountered in these
infections are highly virulent and they are resistant to the most outpatient antibiotics. Special consideration must be
given to identifying the pathogen and selecting suitable antibacterial drug
Keywords: Diabetes, urinary tract infection