The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection

• Main Authors: Morelli Giovanna, Costarelli Silvia, Bonadio Mario, Tartaglia Tiziana
• Format: Article
• Language: English
• Published: BMC 2006-03-01
• Series: BMC Infectious Diseases
• Online Access: http://www.biomedcentral.com/1471-2334/6/54

<p>Abstract</p> <p>Background</p> <p>The role of Diabetes mellitus (DM) in the etiology and in the antimicrobial resistance of uropathogens in patients with urinary tract infection has not been well clarified. For this reason we have evaluated the spectrum of uropathogens and the profile of antibiotic resistance in both diabetic and non diabetic patients with asymptomatic urinary tract infection (UTI).</p> <p>Methods</p> <p>Urinary isolates and their patterns of susceptibility to the antimicrobials were evaluated in 346 diabetics (229 females and 117 males) and 975 non diabetics (679 females and 296 males) who were screened for significant bacteriuria (≥10⁵CFU/mL urine). The mean age of diabetic and non diabetic patients was respectively 73.7 yrs ± 15 S.D. and 72.7 ± 24 (p = NS).</p> <p>Results</p> <p>Most of our patients had asymptomatic UTI. The most frequent causative organisms of bacteriuria in females with and without DM were respectively : <it>E. coli </it>54.1% vs 58.2% (p = NS), <it>Enterococcus </it>spp 8.3% vs 6.5% (p = NS), <it>Pseudomonas </it>spp 3.9 vs 4.7% (p = NS). The most frequent organisms in diabetic and non diabetic males were respectively <it>E. coli </it>32.5% vs 31.4% (p = NS), <it>Enterococcus </it>spp 9.4% vs 14.5% (p = NS), <it>Pseudomonas </it>spp 8.5% vs 17.2% (p = <0.02). A similar isolation rate of <it>E. coli</it>, <it>Enterococcus </it>spp and <it>Pseudomonas </it>spp was also observed in patients with indwelling bladder catheter with and without DM. No significant differences in resistance rates to ampicillin, nitrofurantoin, cotrimoxazole and ciprofloxacin of <it>E. coli </it>and <it>Enteroccus </it>spp were observed between diabetic and non diabetic patients.</p> <p>Conclusion</p> <p>In our series of patients with asymptomatic UTI (mostly hospital acquired), diabetes mellitus <it>per se </it>does not seem to influence the isolation rate of different uropathogens and their susceptibility patterns to antimicrobials.</p>