Abstract

OUTCOMES OF ASYMPTOMATIC BACTERIURIA IN PATIENTS WITH DIABETES MELLITUS IN A YEAR-LONG FOLLOW UP STUDY

Author(s): Ajay Singh, Suraj Godara, Jitesh Ashok Jeswani

BACKGROUND
Diabetes mellitus is a major public health problem worldwide today. It affects the genitourinary system. It predisposes patients
to a variety of urinary tract infections and has long term effects on patient health. Asymptomatic bacteriuria (ASB) in diabetic
patients, its effects on renal function, microalbuminuria, hypertension are not clearly defined. This study was carried out to
determine the prevalence of asymptomatic bacteriuria, its clinical and microbiological outcomes in Indian diabetic patients.
METHODS
Two hundred and fifty type -2 diabetics (100 males and 150 females) without genitourinary symptoms or abnormalities were
included in the study. Midstream urine samples were collected from the study participants after getting informed consent. Urine
samples were examined and processed for the culture using the standard microbiological procedures. The spectrum of
uropathogens causing asymptomatic bacteriuria was noted. Follow up after one year was done to evaluate clinical and
microbiological outcomes.
RESULTS
Among the 250 diabetic patients, 43 (17.2%) had asymptomatic bacteriuria of which 31 (72.1%) were females and 12 (27.9%)
were males. Escherichia coli (37.2%) was the most prevalent organism followed by Klebsiella (13.9%), Enterococcus faecalis
(9.3%), Pseudomonas aeruginosa (6.9%), Staphylococcus aureus (6.9%), Candida species (6.9%), Proteus species (4.7%) and
Coagulase Negative Staphylococcus (4.7%). On follow up it was found that incidence of symptomatic UTI in the study duration
was 10 (23.26%) in the group with ASB and 39 (18.84%) in patients not having ASB at baseline. Prevalence of hypertension
was also similar at the end of one year in both the groups. eGFR, prevalence of microalbuminuria and macroalbuminuria was
also similar in both the groups at one year of follow up.
CONCLUSIONS
The overall prevalence of ASB in the diabetic patients was 17.2%. It was more common in females. Post-menopausal females
have higher prevalence of ASB. E. coli was the most prevalent organism. Risk of symptomatic UTI appears to be comparable to
general diabetic population. Hypertension, renal function and microalbuminuria do not appear to be affected by presence of
ASB.