Bacterial Etiologies, Antimicrobial Susceptibility Patterns and Associated Risk Factors of Urinary Tract Infection among Diabetic Patients Attending Diabetic Clinics in Harar, Eastern Ethiopia

  • Degu Abate
  • Getachew Kabew
  • Fikedu Urgessa
  • Dereje Meaza

Abstract

Background: People with Diabetes Mellitus or problems with the body’s natural defense mechanism are more likely to get Urinary Tract Infections (UTIs). The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of the types of organisms that cause the disease and the selection of an effective antibiotic against the organism in question.
Objective: To assess the prevalence of urinary tract infections, antimicrobial susceptibility patterns and associated risk factors among diabetic patients in Harar, Eastern Ethiopia.
Methods: A facility-based cross-sectional study was conducted among diabetic patients visiting diabetic clinics of five hospitals in Harar town from July 2014 to September, 2014. A structured questionnaire was used for collection of data on socio-demographic and associated risk factors. Mid-stream clean catch urine samples were collected using sterile containers. Culture and antimicrobial susceptibility testing were performed using the standard protocol. The data was entered into Epi-data version 3.15 and analyzed using SPSS version 16. Multivariate logistic regression analysis was conducted to determine the presence of an association between variables using odds ratio with 95% confident intervals and association was declared at P-value <0.05.
Results: A total of 240 diabetic patients participated in this study. Of these 95 (39.6%) of them presented with symptomatic urinary tract infection and the remaining 145 (60.4%) were asymptomatic. Significant bacteriuria was detected in 20% (19/95) and 12.4% (18/145) of symptomatic and asymptomatic diabetic patients respectively. The overall prevalence of urinary tract infection was 15.4% (37/240). The majority of the isolates (70 %) were Gram-negative bacteria. The most frequently isolated bacteria was Escherichia coli (45%) followed by Coagulase-Negative Staphylococci (15 %) and Pseudomonas aeruginosa (10.3%). All bacterial isolates were resistant to at least one antibiotic, and 92.5% of the isolates were resistant to multiple drugs. Previous history of urinary tract infections and female sex were significantly associated with urinary tract infection.
Conclusion: The prevalence of urinary tract infections among diabetic patients attending diabetic clinics in Harar is relative higher when compared to the findings of other studies conducted in different parts of the country and most of the isolates were resistant to multiple antimicrobial agents. Treatment of urinary tract infection among diabetic patients should be based on the result of culture and antimicrobial sensitivity tests.

References

Ampaire, L., Butoto,A., Orikiriza,P. and Muhwezi,O. 2015. Bacterial and Drug Susceptibility Profiles of Urinary Tract Infection in Diabetes Mellitus Patients at Mbarara Regional Referral Hospital, Uganda. British Microbiology Research Journal, 9(4), pp.1-5.
Bonadio, M., Costarelli, S., Morelli, G., and Tartaglia, T. 2006. The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection. BMC infectious diseases, 6(1), p.54
Cheesebrough, M. 1998 .Medical laboratory manual for tropical countries, Microbiology Volume II, Cambridge University Press, London UK, pp. 251-260.
de Lastours, V. and Foxman, B. 2014. Urinary tract infection in diabetes:epidemiologic considerations. Current infectious disease reports, 16(1), p.389.
Demiss, N., Anteneh, A. 2017. Prevalence of uropathogen and their antibiotic resistance pattern among diabetic patients. Turk J Urol 2017; 43(1): 85-92.
Dulawa, J. (2003). Urinary tract infections. Annals of Academic Medical Bialostoc., 49, 182-184
Feleke, Y., Mengistu, Y., Enquselassie, F. 2007. Diabetic infections: clinical and bacteriological study at Tikur Anbessa Specialized University Hospital, Addis Ababa, Ethiopia. Ethiop Med J; 45:171-9.
Geerlings, S.E., Stolk, R.P., Camps, M.J., Netten, P.M., Hoekstra, J.B., Bouter, K.P., Bravenbour, B.E.R.T., Collet, J.T., Jansz, A.R., Hoepelman, A. I. 2000. Asymptomatic bacteriuria may be considered a complication in women with diabetis. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes Care, 23(6), pp.744-749.
Ghenghesh, K.S., Elkateb, E., Berbash, N., Abdel, R., Ahmed, S.F., Rahouma, M.A., Belresh, T., Klena, J.D., Seif-EnnasseElkhabrounr, N. 2009. Uropathogens from Diabetic Patients in Libya: virulence factors and phylogenetic groups of isolated Escherichia coli. .J Med Microbiol., 58(8):1006-14 DOI: 10.1099/jmm.0.007146-0
More inside the PDF
Published
2017-05-11
How to Cite
ABATE, Degu et al. Bacterial Etiologies, Antimicrobial Susceptibility Patterns and Associated Risk Factors of Urinary Tract Infection among Diabetic Patients Attending Diabetic Clinics in Harar, Eastern Ethiopia. East African Journal of Health and Biomedical Sciences, [S.l.], v. 1, n. 2, p. 11 - 20, may 2017. ISSN 2519-917X. Available at: <http://ejol.aau.edu.et/index.php/EAJHBS/article/view/812>. Date accessed: 15 nov. 2018.
Please advise your journal citation style before using the above citation format, you can also find your citation style from citation formats listed down.