Clinico-Microbiological Profile of Urinary Tract Infections in Patients with Type 2 Diabetes: A Study Based in a Hospital Dedicated to Diabetes Care

• Published in: Chronicle of Diabetes Research and Practice Vol. 4; no. 1; pp. 26 - 30
• Main Authors: Shaikh, Suhail M., Tiwari, Shalbha, Purandare, Vedavati B, Bhalekar, Prashant, Bhake, Ragini, Patil, Neelam B, More, Harshal P., Unnikrishnan, Ambika G.
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 2025
• Edition: 2
• Subjects: Brief Communication; Urinary tract infections; Diabetes; Antibiotics; Infection control
• ISSN: 2773-1316; 2773-1324
• DOI: 10.4103/cdrp.cdrp_10_24

Introduction: People with diabetes are prone to urinary tract infections (UTIs). The inappropriate use of antibiotics can lead to the development of multidrug-resistant infections, prolonging patient recovery and significantly increasing healthcare costs. In a hospital focused on diabetes care, it becomes important to ascertain the clinical and microbiological profiles to develop appropriate institutional infection control protocols for managing such patients more effectively on an empirical basis; for this purpose, a pilot study was conducted through a representative sample. Methods: The study included randomly selected 60 patients with UTI: 25 patients were from the wards of the hospital and 20 patients were from the intensive care unit, of whom 10 had complicated UTI with multi-organ dysfunction. The remaining (n = 15) were from the outpatient clinic. Microbiological, and where possible, clinical parameters were studied. Results: The mean age of the subjects was 67.12 ± 9.84 years and the female-to-male ratio was 38: 22; 37 of the 38 women were postmenopausal. The mean duration of diabetes was 15.20 ± 7.93 years. Fifty subjects (83%) had an HbA1C >7%. Thirty-eight (63%) had recurrent UTI episodes. Four (6.7%) were on sodium glucose 2 transport inhibitors and estimated glomerular filtration rate (eGFR) was below 60 mL/min/1.73 m2 in 39 cases (65%). Escherichia coli was the most commonly isolated (59.7%), followed by Klebsiella pneumoniae (25.8%). Amikacin was the most effective antibiotic (86.7%), followed by imipenem, piperacillin-tazobactam, and meropenem. Eleven (18%) required ureteric stenting. Conclusion: In our study, people with diabetes have unique nature of UTI, characterized by predisposition to postmenopausal women, high need for urological procedures and a strong link to low eGFR, older age, long duration diabetes, and high HbA1C. Amikacin could be the choice of antibiotic on empirical basis for inpatient setting, whereas nitrofurantoin could be the preferred oral antibiotic. Taking cognizance of these results, the study emphasizes the need for specialized infection control programs and guidelines for diabetes care settings.