Effect of diabetes on occurrence of urinary tract infection and asymptomatic bacteriuria among diabetic and ketacidosis patients in Egypt

Abstract

Diabetic patients have a higher risk of infections which is the leading trigger of diabetic ketoacidosis. The second most common infection in diabetics is urinary tract infection (UTI). Elevation of glucose level induces an inflammatory process within numerous tissues in the body leading to disturbance in cytokines level and oxidative stress. This study is divided into two parts, firstly it was to investigate the prevalence of asymptomatic bacteriuria (ASB) and urinary tract infections in 84 Type 1 diabetes patients, 63 Type 2 diabetes patients and 57 ketoacidotic patients, and to determine the uropathogens responsible for ASB and UTIs as well as their antimicrobial susceptibility pattern. The second part is to determine the level of IL-1β, IL-6 and superoxide dismutase (SOD) in blood samples of diabetic and ketoacidotic patients. Escherichia coli was the most common isolated bacterial uropathogen followed by Enterococcus faecalis, Staphylococcus saprophyticus and Pseudomonas aeruginosa. These isolates showed 100% sensitivity to cephalothin, imipenem, linezolid, teicoplanin, ceftobiprole and piperacillin-tazobactam. Upon examining cytokines level in diabetic patients, results showed higher levels of IL-1β and IL-6 than control samples, indicating inflammation and disturbance in the regulation of metabolic, regenerative, and neural processes, while SOD examination showed lower levels than control samples, indicating both micro- and macrovascular diabetic complications.