Clinical characteristics and complications of symptomatic bacteriuria in patients with Type 2 diabetes

Abstract

Introduction: Patients with Type 2 diabetes have a higher prevalence of symptomatic bacteriuria, which may predispose to various complications. The aim was to study the clinical characteristics and complications of symptomatic bacteriuria in patients with Type 2 diabetes and factors associated with Escherichia coli symptomatic bacteriuria. Materials and Methods: This was a single-center observational study done on 200 Type 2 diabetes patients admitted with symptomatic urinary tract infection (UTI). Various clinical, biochemical parameters, and urine examination and culture were studied. Results: The prevalence of symptomatic bacteriuria was 69% in Type 2 diabetes patients admitted with UTI. E. coli (55%) was the most commonly isolated organism. Postmenopausal state, longer duration of diabetes, chronic kidney disease, hypertension, and history of symptomatic UTI in a prior year increase the risk of symptomatic bacteriuria. Severe hyperglycemia and acute kidney injury (AKI) occurred more frequently in bacteriuria patients as compared to without bacteriuria (P < 0.001). Upper UTI was significantly associated with symptomatic bacteriuria. Complications such as diabetic ketoacidosis, hyperglycemic hyperosmolar state, and multiorgan dysfunction syndrome were not associated with symptomatic bacteriuria. Poor glycemia, leukocytosis, glycosuria, proteinuria, renal cyst, and renal calculi correlated with symptomatic bacteriuria. Female gender, obesity, and poor glycemia were associated with E. coli symptomatic bacteriuria. Conclusions: Complications do not frequently occur in symptomatic bacteriuria except AKI. Severe hyperglycemia and uncontrolled glycemia need consideration in reducing symptomatic bacteriuria. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, and Systems-based practice.