Asymptomatic bacteriuria and its associated factors in type II diabetes mellitus

Background:  With the dawn of modern era the diabetes epidemic has spread over continents affecting the developed and the developing nations alike. Asymptomatic bacteriuria which is quite prevalent in the diabetic population is associated with increased diabetic complications and thereby increased morbidity. Thus, the aim of this study was to assess the proportion of cases with asymptomatic bacteriuria (ASB) among type II diabetes mellitus patients as compared to non-diabetic healthy controls and studying the factors associated with ASB. Methods: 93 eligible type II diabetes mellitus cases without genitourinary symptoms or abnormalities along with 93 non-diabetic healthy controls were recruited. Mid-stream urine was collected after taking informed consent and each sample tested using the dipstick, microscopy and culture techniques. Isolates were identified using standard biochemical tests. Results:  Prevalence of ASB in our study was found to be 34.4% among cases of type II diabetes mellitus while it was 6.45% among non-diabetic healthy controls. Amongst the diabetics with ASB 71.9 % were females and 28.13 % were males. E. Coli was isolated in 21 subjects among diabetic cases (22.58%) and in 5 subjects among non-diabetic healthy controls (5.38%). Fasting blood sugar (FBS) in diabetic cases group was 151.08 ± 48.16 and in control group was found to be 98.57 ± 25.95 (p<0.001). Mean duration of patients with DM who had ASB (32) was 8.46 ± 4.14 years and those who were culture negative was 4.59 ± 4.2 years (p < 0.05). 24 subjects (75%) out of 32 diabetic ASB cases had glycosuria compared to 27 subjects (44.26%) out of 61 culture negative cases (p < 0.05). 9 out of 32 (28.13%) diabetic ASB subjects had proteinuria compared to 4 out of 61 (6.56%) culture negative cases (p < 0.05). Conclusions:  Overall prevalence of ASB was significantly more in diabetic population as compared to non-diabetic healthy controls (34.4% vs 6.45%). Females have an increased likelihood of developing ASB as compared to males. E. Coli was the most common pathogen isolated in ASB cases. Longer duration of diabetes and poor glycemic control are independent predictors for the development of ASB. The risk of ASB is also significantly increased in those with glycosuria and proteinuria.