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ASYMPTOMATIC BACTERIURIA IN WOMEN WITH DIABETES MELLITUS
ASYMPTOMATIC BACTERIURIA IN WOMEN WITH DIABETES MELLITUS
Aza Bahadeen Taha * and Sabria M. Said Al-Salihi *
* College of Nursing, Hawler Medical University, Erbil.
Submitted: 23/12/2014; Accepted: 12/5/2015; Published 1/12/2015
DOI Link: https://doi.org/10.17656/jsmc.10074
ABSTRACT
Background
Asymptomatic bacteriuria is a problem in women with diabetes mellitus and may lead to urinary tract infection. Escherichia coli remains the single most common bacteria isolated from asymptomatic bacteriuria in women.
Objectives
To determine the prevalence and antibiotics resistance profile of asymptomatic bacteriuria among women with diabetes mellitus, this is important for epidemiological study.
Methods
A total of 600 non-pregnant women with diabetes (type 1 and type 2), and 300 women without diabetes (control group) were screened for asymptomatic bacteriuria. All the women were free from any symptoms of urinary tract infection. Two separate clean catch midstream urine samples were collected, examined microscopically and cultured. Bacteria were isolated and identified using standard bacteriological methods. Antibiotic susceptibility testing was performed using standard disk-diffusion assays.
Results
Asymptomatic bacteriuria was detected in 15.67% of diabetic women (14.33% in type 1 and 17.00% in type 2), and 3.67% in non-diabetic women (P<0.001). Escherichia coli (58.51%) was the most prevalent pathogen isolated in diabetic subjects. Most of the bacteria were resistant to Ceftriaxone (85.11%), Cefixime (73.40%), and Trimethoprim (73.40%).
Conclusion
Asymptomatic bacteriuria is not uncommon among diabetic women and might be added to the list of diabetic complications in these women.
KEYWORDS
Diabetes Mellitus, Bacteriuria, Asymptomatic, UTI, Antibiotics Resistance.
References
1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27(5):1047-53.
2. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87(1):4-14.
3. Renko M, Tapanainen P, Tossavainen P, Pokka T, Uhari M. Meta-analysis of the significance of asymptomatic bacteriuria in diabetes. Diabetes Care 2011;34(1):230-5.
4. Schneeberger C, Kazemier BM, Geerlings SE. Asymptomatic bacteriuria and urinary tract infections in special patient groups: women with diabetes mellitus and pregnant women. Curr Opin Infect Dis 2014;27(1):108-14.
5. Shah BR, Hux JE. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 2003;26(2):510-3.
6. Muller LM, Gorter KJ, Hak E, Goudzwaard WL, Schellevis FG, Hoepelman AI, et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2005;41(3):281-8.
7. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Hoekstra JB, Bouter KP, et al. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes Care 2000;23(6):744-9.
8.Bertoni AG, Saydah S, Brancati FL. Diabetes and the risk of infection-related mortality in the U.S. Diabetes Care 2001;24(6):1044-9.
9. Boroumand MA, Sam L, Abbasi SH, Salarifar M, Kassaian E, Forghani S. Asymptomatic bacteriuria in type 2 Iranian diabetic women: a cross sectional study. BMC Womens Health 2006;6:4.
10. Brown JS, Wessells H, Chancellor MB, Howards SS, Stamm WE, Stapleton AE, et al. Urologic complications of diabetes. Diabetes Care 2005;28(1):177-85.
11. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Collet TJ, Hoepelman AI, et al. Risk factors for symptomatic urinary tract infection in women with diabetes. Diabetes Care 2000;23(12):1737-41.
12. Nicolle LE. Asymptomatic bacteriuria--important or not? N Engl J Med 2000 5;343(14):1037-9.
13. Ribera MC, Pascual R, Orozco D, Perez Barba C, Pedrera V, Gil V. Incidence and risk factors associated with urinary tract infection in diabetic patients with and without asymptomatic bacteriuria. Eur J Clin Microbiol Infect Dis 2006;25(6):389-93.
14. Geerlings SE, Meiland R, Hoepelman AI. Pathogenesis of bacteriuria in women with diabetes mellitus. Int J Antimicrob Agents 2002;19(6):539-45.
15. Geerlings SE, Brouwer EC, Gaastra W, Verhoef J, Hoepelman AI. Effect of glucose and pH on uropathogenic and non-uropathogenic Escherichia coli: studies with urine from diabetic and non-diabetic individuals. J Med Microbiol 1999;48(6):535-9.
16. Wheat LJ. Infection and diabetes mellitus. Diabetes Care 1980;3(1):187-97.
17. Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999;26(3-4):259-65.
18. Geerlings SE. Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment. Int J Antimicrob Agents 2008;31 Suppl 1:S54-7.
19. Zhanel GG, Harding GK, Nicolle LE. Asymptomatic bacteriuria in patients with diabetes mellitus. Rev Infect Dis 1991;13(1):150-4.
20. Nicolle LE, Zhanel GG, Harding GK. Microbiological outcomes in women with diabetes and untreated asymptomatic bacteriuria. World J Urol 2006;24(1):61-5.
21. Raz R. Asymptomatic bacteriuria. Clinical significance and management. Int J Antimicrob Agents 2003;22 Suppl 2:45-7.
22. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2005;40(5):643-54.
23. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2010;50(5):625-63.
24. Bissong ME, Fon PN, Tabe-Besong FO, Akenji TN. Asymptomatic bacteriuria in diabetes mellitus patients in Southwest Cameroon. Afr Health Sci 2013;13(3):661-6.
25. Cowan ST, Steel KJ, Barrow G, Feltham R. Cowan and Steel’s manual for the identification of medical bacteria: Cambridge university press; 2003.
26. Cockerill FR, Clinical, Institute LS. Performance standards for antimicrobial disk susceptibility testing: approved standard: National Committee for Clinical Laboratory Standards; 2012.
27. Schneeberger C, Stolk RP, Devries JH, Schneeberger PM, Herings RM, Geerlings SE. Differences in the pattern of antibiotic prescription profile and recurrence rate for possible urinary tract infections in women with and without diabetes. Diabetes Care 2008;31(7):1380-5.
28. Andriole VT. Asymptomatic bacteriuria in patients with diabetes--enemy or innocent visitor? N Engl J Med 2002;347(20):1617-8.
29. Keane EM, Boyko EJ, Reller LB, Hamman RF. Prevalence of asymptomatic bacteriuria in subjects with NIDDM in San Luis Valley of Colorado. Diabetes Care 1988;11(9):708-12.
30. Ooi ST, Frazee LA, Gardner WG. Management of asymptomatic bacteriuria in patients with diabetes mellitus. Ann Pharmacother 2004;38(3):490-3.
31. Zhanel GG, Nicolle LE, Harding GK. Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America 1995;21(2):316-22.
32. Bessman AN, Sapico FL. Infections in the diabetic patient: the role of immune dysfunction and pathogen virulence factors. J Diabetes Complications 1992;6(4):258-62.
33. Bonadio M, Boldrini E, Forotti G, Matteucci E, Vigna A, Mori S, et al. Asymptomatic bacteriuria in women with diabetes: influence of metabolic control. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2004;38(6):e41-5.
34. Harding GK, Zhanel GG, Nicolle LE, Cheang M. Antimicrobial treatment in diabetic women with asymptomatic bacteriuria. N Engl J Med 2002;347(20):1576-83.
35. Carey B, Cryan B. Antibiotic misuse in the community--a contributor to resistance? Ir Med J 2003;96(2):43-4, 6.
36. Willemsen I, Bogaers-Hofman D, Winters M, Kluytmans J. Correlation between antibiotic use and resistance in a hospital: temporary and ward-specific observations. Infection 2009;37(5):432-7.
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