CAUSATIVE AGENTS OF URINARY TRACT INFECTION IN DIABETIC PATIENTS AND THEIR PATTERN OF ANTIBIOTIC SUSCEPTIBILITY

ABSTRACT OBJECTIVES: To determine the etiologic agents of urinary tract infection (UTI) and their antibiotic susceptibility patterns among diabetic patients. METHODS: This cross-sectional observational study was conducted from 1 st August 2016 to 28 th Feb 2017 at Cantonment General Hospital Rawalpindi, Pakistan. A consecutive non-probability sampling technique was used to screen diabetic patients for UTIs irrespective of their symptoms. Subjects from both genders and aged more than 18 years were included. Urine cultures were taken and uropathogens were isolated and tested for drug susceptibility following standard laboratory procedures. RESULTS: Out of 209 diabetic patients, 106 (50.7%) had culture positive UTI, 77/106 (72.6%) were females. Mean age of patients with UTI was 49.9±9.80 years. Ninety-eight (93.5%) had type 2 diabetes and with a mean duration of 8.25±3.78 years. Mean HbA1c level was 9.63±2.001 % . Thirty-five (33%) patients had HbA1c >11, 52 (49.1%) patients had HbA1c values ranging between 7 to 11% and 19 (17.8%) patients had HbA1c level of <7%. Eschericia coli (E coli) was the most common uropathogen (80%) followed by Enterobacter (7.6%), citrobacter (6.7%), morganella (4.8%) and pseudomonas (1%). No gram positive bacteria were isolated. Fosfomycin was 100% sensitive against all uropathogens. Meropenum, piperacillin-Tazobactum and cefoperazone-salbactum were 91.4%, 88.6% and 86.7% sensitive respectively, whereas amikacin was 72.4% sensitive. Chloramphenicol, doxycycline and amoxicillin/culvunate showed sensitivity of 66.7%, 61% and 40% respectively. Cephalosporins and quinolones were least sensitive classes. CONCLUSION : E coli were the most common uropathogens in diabetics. Fosfomycin, Meropenum, piperacillin-Tazobactum and cefoperazone-salbactum had good sensitivity profile against uropathogens in diabetics. KEY WORDS :  Diabetes Mellitus (MeSH), Urinary Tract Infections (MeSH), Antibiotics (MeSH)