Symptomatic and Asymptomatic Bacteriuria and Drug Susceptibility Pattern of Urinary Tract Infections among Diabetic Patients Attending at Tikur Anbessa Specialized University Hospital, Addis Ababa.

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Addis Ababa University


Background: The risk of developing infection in diabetic patients is higher and urinarytract is the most common site for infection. Urinary tract infection (UTI) may besymptomatic or asymptomatic. The etiology of UTI and the antibiotic resistance of uropathogens have been changing over the past years. In Ethiopia, there are some published information concerning community acquired and hospital acquired UTIs, butno study was conducted in asymptomatic bacteriuria and antimicrobial susceptibility pattern for UTIs in Ethiopian diabetic patients. Objective: The aim of the study was to identify the prevalence of symptomatic and asymptomatic bacteriuria, to isolate the bacterial pathogens and determine drug susceptibility pattern of urinary tract infections among diabetic patients attending Diabetic referral clinics at Tikur Anbessa Specialized University Hospital, Addis Ababa. Methods: A cross sectional survey was conducted by systematic sampling technique by taking every other diabetic patient coming to diabetic referral clinics and admitted to medical wards and medical Intensive Care Unit (ICU). A total of 413 diabetic patients were selected during the study period from June 2009to August2009. Results: ine (13.6%) of the symptomatic DM patients had bacteriuria compared with thirty six(10.4%) of asymptomatic DM patient. The overall prevalence of UTI in both groups was 45(10.9%).The bacterial pathogens isolated were predominantly gramnegative and two isolates were gram positive. Of the gram negative isolates the most common organism was Escherichia coli, 6% and 28% followed by Klebsiellapneumoniae, 2% and 6% in the symptomatic and asymptomatic DM patientsrespectively. The other gram negative organisms found in small numbers were Pseudomon as aeruginosa, 1(0.2%) and Enterobacter clocace, 1(0.2%). The only isolatefrom gram positive was Entrococcusspp.2 (0.5%).The susceptibility testing results of the isolates showed that over 85%Escherichia colistrains were sensitive to ciprofloxacin, Amoxicillin-Clavulanic acid, ceftizadine, nitrofuranton, ceftiraxone, norfloxacin and kanamycin(85.3–94.1%),but there was a higher rate of resistant to both ampicillin (67.6%), tetracycline (64.7%) and Trimethoprim -sulphamethoxazole (64.7%).Klebsiella pneumoniaewere 100% sensitiveto ciprofloxacin, ceftazidime, ceftiraxone and over 85% sensitive to gentamycin (87.5%)butshowed a high rate of resistance(75%) to ampicillin, tetracyclin and Trimethoprim-sulphamethoxazole.The frequency of multiple resistances for two or more drugs amongthe urinary pathogenswere found in thirty three(71.7%) of the isolates. Conclusion:The prevalence of urinary tract infection in this study ishigh in women thanmen and also pyuria and glucosuria can be considered as strong association withbacteriuria.Escherichia coli was the most commonbacterial pathogen isolated in bothsymptomatic and asymptomaticbacteriuria. Remarkablyover (60%) of all isolates were resistances to ampicillin, tetracycline and Trimethoprim-sulphamethoxazolehave beenfound in this study. Therefore, the investigation of bacteriuria in diabetic patients by screening for urinary tract infection is very important as it enables to treat properly andprevent the development of renal complications and eventually severe renal damage andfailure.



Asymptomatic bacteriuria,bacteriuria,Diabetes Mellitus,prevalence, pyuria,symptomaticbacteriuria,urinary tractinfection, Ethiopia.