Frequency of Urinary Tract Infection, Microbial Patterns and Drug Resistance in Diabetic Patients in a Tertiary Care Unit
Keywords:
Diabetes Miletus, Urinary Tract Infection, E. Coli, Antibiotic Resistance, Aminoglycosides, Quinolones.Abstract
Objective: To determine the frequency of UTIs in people with diabetes and identify local bacterial flora and antibiotic resistance.
Methodology: An observational, analytical, cross-sectional study was conducted at the Medicine Ward of Jinnah Medical and Dental College Hospital (now Sohail Trust Hospital) from January-December 2020. A convenient sampling technique was applied, and the sample size was 132. Diabetic patients >18 years of age were included. Data was collected on a structured questionnaire. A urine sample was sent for culture sensitivity. Any growing flora and their sensitivity/resistance to antibiotics were recorded. All the data were analysed using SPSS version 21.
Results: UTI was found in 31(23.5%) patients. Female gender, insulin therapy, and lower creatinine clearance were related to UTI, as shown by significant p values. Most common flora was E. Coli 26(84%), followed by Klebsiella 4(13%) and S. aureus 1(3%). E.Coli was 100% resistant to 3rd generation cephalosporins, 83.9% resistant to quinolones and 67.7% resistant to Penicillin (amoxicillin/clavulanic acid) and 43% resistant to aminoglycosides. Klebsiella was 100% resistant to Penicillin and quinolones and 85% to 3rd generation cephalosporin. E. coli and Klebsiella were 100% sensitive to carbapenems, nitrofurantoin and Fosfomycin, whereas S. Aureus was resistant to cloxacillin, clindamycin and clindamycin and quinolones, while sensitive to vancomycin., linezolid and aminoglycosides.
CONCLUSION: UTI was found in 23.5% of our diabetic patients; the most common organisms prevalent were E. Coli, Klebsiella and S. aureus, which was primarily resistant to Penicillins, Cephalosporins and quinolones while sensitive to nitrofurantoin, Fosfomycin and carbapenems.
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