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Prevalence of Uropathogens and their Antibiogram in Diabetic Patients A Cross Sectional Study

Diabetes mellitus is a chronic, progressive metabolic disorder resulting from loss of loss of early insulin secretion and development of early insulin resistance. Higher frequency of UTI and related complications among diabetics may be attributed to different mechanisms including immune function impairments and higher levels of glucose in urine may contribute to growth of pathogens. This study evaluated the uropathogens in diabetic UTI and their antibiogram. The present study was conducted from 1348 patients sample in Central Clinical Microbiology Laboratory of Narayana General and Super Speciality Hospital for a period of 12 months. Patients attending the Department of Urology diagnosed with Urinary Tract Infections (UTI) and known diabetics and newly diagnosed diabetics were also included in the study. 10ml of clean voided mid stream sample was obtained from all included cases after appropriate instructions. Culture method was done by Blood agar, MacConkey agar plates. Anti microbial susceptibility testing was performed for the isolates by Kirby-Bauer disc diffusion method to different antimicrobial agents. Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923 were used as control organisms. The results were interpreted as per CLSI guidelines. SPSS version 14.0 was used for analysis of data. Escherichia coli was the major uropathogen (27.79%) followed in order by Klebsiella pneumoniae (16.00%), Pseudomonas aeruginosa (13.43%), Staphylococcus aureus (12.00%) and other uropathogens were Proteus sp (6%), Acinetobacter sp (6.36%), Citrobacter sp (3.86%), Serratia sp (0.71%), Staphylococcus saprophyticus (7.29%), Enterococci sp (3.86%). C. albicans (2.71%) was the only fungal pathogen isolated in the study. Escherichia coli the major pathogen exhibited maximum sensitivity to carbapenems (98%) followed by piperacillin+tazobactum (91%), and maximum resistance was noted to ampicillin (88%) and moderate degree of sensitivity to cefixime, ofloxacin and amikacin (>80%). Almost similar degree of sensitivity was noted among other uropathogens exhibiting maximum sensitivity to carbapenems, Serratia sp exhibited maximum sensitivity to all antibiotics (>95%) except trimethoprim +sulphomethoxazole and ampicillin. Among Gram positive pathogens 100% sensitivity was noted to vancomycin and linezolid and maximum resistance noted to Ampicillin. Amikacin and piperacillin+tazobactum exhibited >90% sensitivity to all gram positive pathogens. The prevalence of UTI and ASB was high among diabetic females than in males. Females and males more than 50 years of age post menopausal age were at more risk of acquiring UTI than in young adults. E. coli was the most common isolate in ASB cases and maximum sensitive to carbapenems. S. aureus was common among gram positive pathogens with maximum sensitivity to vancomycin and linezolid. K e y w o r d s