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Asymptomatic bacteriuria in diabetes mellitus.

SUMMARY A study was undertaken to determine the frequency of asymptomatic bacteriuria among 100 ambulant diabetic patients attending a diabetic outpatient clinic. At the same time, we assessed the reliability of the Uricult dip-slide method for detecting urinary bacterial growth. Significant bacteriuria occurred in 9% of the total diabetic group, largely attributable to the high prevalence in elderly diabetic women. Important characteristics of the affected diabetic patients included infection, commonly with Escherichia coli, frequently associated pyuria, good diabetic control with normal renal function and a high recurrence rate of bacteriuria after treatment. The dip­ slide method compared quite favourably with the labora­ tory culture method, but it failed to detect 2 out of 8 cases with significant bacteriuria. S. Afr. Med. J., 48, 1306 (1974). Whether patients with diabetes mellitus have an increased susceptibility to urinary tract infections remains a con­ troversial issue. Much of the conflicting literature has been reviewed by Thomsen.' A recent investigation indi­ cated that true bacteriuria in the diabetic occurred almost exclusively in females, and especially in the older age groups.' In the present study we re-evaluate the problem in a representative group of diabetic outpatients, and assess the usefulness of the Uricult dip-slide (Orion Laboratories, Helsinki) as a reliable screening technique. The dip-slide method has been satisfactorily employed in a variety of other clinical situations, including paediatric practice; protein calorie malnutrition; urological units' and obstetric patients!