Urinary tract infections and antimicrobial sensitivity among diabetic patients at Khartoum, Sudan

Annals of Clinical Microbiology and Antimicrobials

Research

Amar M Adam¹  Hamdan Z Hamdan¹  Eman Kubbara¹  Ishag Adam²  Sarah O Suliman³  Onab S Hassan⁴ 

[1] Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Neelain University, P.O. Box 12702, Khartoum, Sudan;Department of Obstetrics and Gynecology, Faculty of Medicine, Khartoum University, P.O. Box 102, Khartoum, Sudan;Faculty of Medical Laboratory, Omdurman Al-Ahlia University, Omdurman, Sudan;Faculty of Pharmacy, Al-Yarmouk University College, Khartoum, Sudan;

关键词: Diabetes;    Urinary tract infection;    Bacteriuria;    E. coli;    K. pneumoniae;    Sudan;   

DOI  :  10.1186/s12941-015-0082-4

 received in 2014-11-12, accepted in 2015-03-23,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPatients with diabetes mellitus (DM) are more susceptible to urinary tract infection (UTI) than non-diabetics. Due to the emergence of multidrug resistant (MDR) uropathogenic strains, the choice of antimicrobial agent is restricted. This study investigated the epidemiology of UTI, antimicrobial susceptibility, and resistance patterns of bacterial isolates from adult diabetic patients.MethodsA cross-sectional study was conducted at Khartoum Hospital, Sudan during the period of March − September 2013. Consecutive patients (men and women) were approached to participate in the study, irrespective of UTI symptoms. Socio-demographic and clinical data were obtained from each participant using pre-tested questionnaires. Clean-catch, midstream urine samples were collected and cultured for UTI diagnosis and antimicrobial susceptibility. Symptomatic bacteriuria was defined as a positive urine culture (≥105 colony-forming units [CFU]/mL of a single bacterial species) from patients with symptoms associated with UTI; asymptomatic bacteriuria was defined as a positive urine culture from patients without symptoms associated with UTI.ResultsA total of 200 diabetic patients were enrolled, 121 (60.5%) men and 79 (39.5%) women; 193 (96.5%) had type II DM. The overall prevalence of UTI was 39 (19.5%). Among the total population, 17.1% and 20.9% had symptomatic and asymptomatic bacteriuria, respectively. According to multivariate logistic regression, none of the investigated factors (age, sex, type of DM and duration) were associated with UTI. The predominant isolates were Escherichia coli (22, [56.4%]), and Klebsiella pneumoniae, [9, (23%)]. Eight of 22 E. coli, four of nine K. pneumoniae and one of five Enterococcus faecalis isolates originated from symptomatic patients. Six, four, three, and two of 22 E. coli isolates showed resistance to ampicillin, co-trimoxazole, nitrofurantoin, and amoxicillin-clavulanic acid, respectively. Two, two, one and one of nine K. pneumoniae isolates were resistant to ampicillin, co-trimoxazole, cephalexin, and amoxicillin-clavulanic acid. All 22 E. coli isolates were sensitive (100%) to gentamicin and cephalexin. All nine K. pneumoniae were sensitive to gentamicin (100%) and 88.8% were sensitive to cephalexin.ConclusionIn Sudan, about one-fifth of diabetic patients have UTI. E. coli is the most frequent isolate followed by K. pneumoniae.

【 授权许可】

CC BY   
© Hamdan et al.; licensee BioMed Central. 2015