July 02, 2020
Prospective study of the epidemiology and characteristics of UTI in people with or without diabetes 1
In people with diabetes mellitus, associated dysfunction of both the immune system and bladder leaves them prone to UTIs. For timely diagnosis and optimal management, it is important to screen for UTIs in patients with diabetes. The aim of this study was to compare the incidence and clinical and microbiological features of UTI in patients with and without diabetes
- Prospective, observational, cross-sectional, comparative study employing an adapted, consecutive non-probability sampling technique.
- Diabetes mellitus patients were recruited from a hospital outpatient department; a non-diabetes control group was selected from the attendants of the diabetes group.
- Compared with the diabetes group (n=256), the non-diabetes group (n=250) were younger (mean age 48 vs 56 years) and had a higher proportion of women (62% vs 56%).
- Culture-positive UTI was identified in 13.7% of the diabetes group and in 7.2% of the non-diabetes group – overall risk of UTI was two-fold higher in the diabetes group.
- UTI was more common in females of both groups, and among females with diabetes the risk of UTI was almost five times higher than in females without diabetes.
- Culture-proven UTI was asymptomatic in 30% of cases in the diabetes group versus only 5% of cases in the non-diabetes group.
- Escherichia coli was the most common pathogen identified in both groups; Pseudomonas aeruginosa was identified in 1 in 7 cases in the diabetes group with culture positive UTI but in no cases in the non-diabetes group.
UTIs are more common in people with, versus without, diabetes. Asymptomatic bacteriuria is also more common in diabetes patients but does not require treatment.