Comparative Study: The Incidence of Urinary Tract Infection in diabetic Patients in the Eastern Region of Libya and their Antibiotics Sensitivity Pattern

Abstract

Urinary tract infections (UTIs) are one of the most common infections in both outpatient and inpatient settings. The term urinary tract infection applies to a heterogeneous group of clinical syndromes. Clinical entities in “UTI” include asymptomatic bacteriuria, acute uncomplicated cystitis, recurrent cystitis, complicated UTI, catheter-associated asymptomatic bacteriuria, catheter-associated UTI (CAUTI), prostatitis, and pyelonephritis. Appropriate classification of UTI syndrome is crucial for optimal diagnosis and management. The various categories of UTI are distinguished by the presence or absence of symptoms referable to the urinary tract; the patient’s sex and comorbid conditions.UTI is a common infection observed in diabetic patients due to high level of sugar in the urine and often incomplete empting bladder from damage to bladder nerve . There is usually burning pain when passing urine , a need to pass urine frequently or sometimes discomfort in lower abdomen or blood in the urine (hematuria). Most simple urinary infections respond well to three to five days of oral antibiotic. Generally a fever ,back or flank pain suggest kidney infections which will usually need intravenous antibiotic . comparative study collected from 200 UTI diabetic patients between our data research of master degree in Benghazi during one year from Jan 2014 to Dec 2014. Compare with 110 samples UTI diabetic patients in Tobruk Medical Center during six months from Jan 2018 to Jun 2018.

In the present study the most common uropathogens E.coli followed by Candida spp , Klebsiella , Staphylococcus aureus , Coagulase negative staphylococci, Pseudomonas spp, Proteus, and Enterococcus spp. The result found highly resistance in diabetic patients to antimicrobial especially Pseudomonas spp. The effective antibiotics are Nitrofurantoin , Ciprofloxacin, Ceftriaxone and Vancomycin. in our study we found that the incidence of UTIs was higher among diabetic patients (women and men) age between 41 to 50 (70.5%) as compared to age group of 31-40 years i.e 67% with a difference of about 38% less percentage of UTI was found in age group of 20-30 i.e (20%) and the results agree with those demonstrated by Nicolle et al., 1996 (7) who found that both men and women with diabetes have an increased risk of acute infection requiring hospital admission and which may increase the probability of 20 to 30 fold under the age of 44 and three to five fold over the age of 44.diabetic patient with UTI in both gram positive and negative bacteria showed significant level of resistance to most antimicrobial agents tested. Multidrug resistance to two or more drugs was observed in bacterial isolates. Also candida spp most common in diabetic patients.