PREVALENCE OF ASYMPTOMATIC BACTERIURIA WITH TYPE 2 DIABETES IN A TERTIARY CARE CENTRE IN ANDHRA PRADESH AND CLINICAL IMPLICATIONS

Abstract

Daveleswarapu Markendeyulu1, Gurrala Surya Narayana Murthy2

BACKGROUND & OBJECTIVES
Asymptomatic bacteriuria1 in diabetes2 if left untreated, may lead to uncomplicated UTI3, acute pyelonephritis, AKI, ultimately lead to CKD. Tight control of hyperglycaemia and early treatment ABU in patients with prolonged duration with comorbid conditions reduces the incidence of these complications. The present study was done to determine presence of asymptomatic bacteriuria (ABU)1,4 and treatment5 at the earliest to prevent serious complications.
METHODS
A prospective study was conducted at a tertiary care teaching hospital of Andhra Pradesh from April 2014 to March 2015. 102 cases reported with ages 30-70 years age, having no urinary complaints were included. Their mid-stream urine sample was sent for culture and sensitivity. Women having >106 colony forming units/mL of single organism were diagnosed7 positive for ABU and treated.8 They were followed till the cultures were negative with HbA1c is near normal.
RESULTS
ABU was found in 56.86% women and in 19.67% in men. Increased incidence in women with poor glycaemic control, HbA1c is the marker for Diabetes control.
MATERIALS AND METHODS
Total 102 T2DM patients were studied, with FBS >160 mg/dL, PPBS >300 mg/dL, with no signs and symptoms of UTI, and were afebrile, other renal functions like s. creatinine, BUN, spot urine protein/creatinine ratio were normal. US abdomen was a normal study. Mid-stream urine samples of all patients were cultured and microscopically studied. Culture of microorganisms in urine was done on CLED (Cystine Lactose Electrolyte Deficient) medium/MacConkey agar and blood agar using standard loop (Std. size 3 mm internal diameter).7
INTERPRETATION & CONCLUSIONS
ABU will not produce symptoms but early detection and treatment9 reduces the complications of diabetes and early onset of renal diseases in the form of pyelonephritis, AKI may lead to CIN and CKD.

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