IJCRR - 7(21), November, 2015
Pages: 13-18
STUDY OF CLINICO-PATHOLOGICAL AND BACTERIOLOGICAL PROFILE OF URINARY TRACT INFECTIONS IN GERIATRIC PATIENTS WITH TYPE 2 DIABETES MELLITUS
Author: Bhumika Vaishnav, Arvind Bamanikar, Pragati Maske, Vivek Singh Rathore, Vinit Khemka, Deepshikha Sharma
Category: Healthcare
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Abstract:
Introduction: The elderly with type2 Diabetes Mellitus(DM) have a greater frequency and severity of urinary tract infections(UTIs) due to long duration of DM, its neurovascular complications, long term insulin use, aging and suppression of immune system. The term UTI encompasses asymptomatic bacteriuria (ABU), urethritis, cystitis, prostatitis and pyelonephritis.
Aims: To study the clinical and microbiological profileof UTI in patients more than 60 years of age having type2 DM. To examine whether the presence of diabetes alters the risks and complication profile for UTI’s in elderly.
Materials and Methods: Cross-sectional, analytical study of elderly diabetic patients with UTI diagnosed on the basis of detailed clinical history and investigations.
Results: Out of 60 study subjects, 24 were male and 36 were female with maximum incidence of UTI occurring in 65-69 years of age group. 66.67% of patients had diabetes for more than 10 years and more than 70% were on insulin therapy. HbA1c valu was greater than 8 in 66.67% subjects. Foul smelling urine, dysuria and urgency were the commonest symptoms. Escherchiacoli (E coli) was the commonest pathogen isolated in 70% patients. 26.67% subjects had complicated UTI’s and acute kidney injury was the common complication
Conclusion: E. Coli is the commonest organism causing UTI in elderly diabetics. There was no gender difference in the incidence of UTI. The possible risk factors for UTI in elderly diabetics are long duration of disease (more than 10 years), prolonged insulin therapy and high HbA1c values..
Keywords: Urethritis, Asymptomatic bacteriuria, Diabetes mellitus, E. coli
Citation:
Bhumika Vaishnav, Arvind Bamanikar, Pragati Maske, Vivek Singh Rathore, Vinit Khemka, Deepshikha Sharma. STUDY OF CLINICO-PATHOLOGICAL AND BACTERIOLOGICAL PROFILE OF URINARY TRACT INFECTIONS IN GERIATRIC PATIENTS WITH TYPE 2 DIABETES MELLITUS International Journal of Current Research and Review. 7(21), November, 13-18
References:
1. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J; Diabetes mellitus, Harrison’s principles of internal medicine, 18th edition, chap. 344, pg no.2974.
2. Bonadio M, Costarelli S, Morelli G, Tartaglia T. The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection. BMC Infect Dis. 2006: 17(6),54.
3. Brauner AM, Flodin U, Hylander B, Östenson CG. Bacteriuria, Bacterial Virulence and Host Factors in Diabetic Patients, Diabetic Medicine; 1997:10(6), 550–554.
4. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Hoekstra JB, Bouter KP. Asymptomatic bacteriuria may be considered a complication in Women with diabetes mellitus Utrecht Study Group. Diabetes Care; 2000:23(6), 744-749.
5. Boyko EJ,Fihn SD, Scholes D. Diabetes and the Risk of Acute Urinary Tract Infection Among Postmenopausal Women. Diabetes Care; 2002: 25(10), 1778-1783.
6. Gilbert GG, Donders MD. Lower genital tract infections in diabetic women. Current Infectious Disease Reports; 2002: 4(6), 536-539.
7. Hoepelman AIM, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. International Journal of Antimicrobial Agents; 2003:22(2), 35–43.
8. Patterson JE, Andriole VT. Bacterial urinary tract infections in diabetes. Infect Dis Clin North Am; 1995: 9(1), 25-51.
9. Minardi D, d’Anzeo G, Cantoro D, Conti A, Muzzonigro G. Urinary tract infections in women: etiology and treatment options. Int J Gen Med. 2011; 4: 333–343
10. Janifer J, Geethalakshmi S, Satyavani K, and Viswanathan V. Prevalence of lower urinary tract infection in South Indian type 2 diabetic subjects. Indian J Nephrol; 2009; 19(3): 107–111.
11. Schmitt JK, Fawcett CJ, Gullickson G. Asymptomatic bacteriuria and hemoglobin A1c. Diabetes Care. 1986;9:518– 20.
12. Raz R, Gennesin Y, Wasser J, Stoler Z, Rosenfeld S, Rottensterich E, et al. Recurrent urinary tract infections in post menopausal women. Clin Infect Dis. 2000;30:152–6.
13. Marques LP, Flores JT, Barros Junior Ode O, Rodrigues GB, MourãoCde M, Moreira RM. Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women.Braz J Infect Dis: 2012;16(5):436-41.
14. Goswami R, Bal CS, Tejaswi S, Punjabi GV, Kapil A, Kochupillai N. Prevalence of urinary tract infection and renal scars in patients with diabetes mellitus. Diab Res Clin Pract.2001;53:181–6.
15. Geerlings SE, Meiland R, van Lith EC, Brouwer EC, Gaastra W, Hoepelman AIM. Adherence of type 1-fimbriaeted E. coli to uro epithelial cells: More in diabetic women than in control subjects. Diab care. 2002;25:1405–9.
16. Aswani SM, Chandrashekar U, Shivashankara K, Pruthvi BC. Clinical profile of urinary tract infections in diabetics and nondiabetics; Australas Med J.
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