Urinary tract infection in diabetic patients with special reference to klebsiella species

Diabetes mellitus [DM] is a metabolic disease which is accompanied by increased susceptibility to infection. This study was performed to determine the prevalence of urinary tract infection [UTI] in a group of diabetic patients and to identify the most common causative organisms with special reference to Klebsiella species and to assess antimicrobial sensitivity of the isolated strains of Klebsiella. The study included 618 diabetic patients along with 100 age- and sex- matched non-diabetic individuals as controls. Urine was obtained by clean catch midstream method. Bacterial colony count and culture on blood agar and MacConkey agar were performed. Isolation and identification of the causative organisms were done by the standard microbiological techniques. Antibiotic sensitivity was done for the isolated Klebsiella strains using agar dilution technique. Results showed an increase in prevalence of significant bacteriuria in diabetic [30.91%] than in non-diabetic individuals [13%] with a higher frequency of infection in females and in older age group. There was no significant difference between both types of diabetes. However, patients with longer duration of disease [25.69%] were significantly [P < 0.001] more liable to have significant bacteriuria than those with shorter duration of the disease [38.28%]. Most diabetic patients with UTI were asymptomatic [69.63%] and the most common organisms found were E. coli [32.22%] and Klebsiella [23.33%] with prevailing K. pneumoniae followed by K. oxytoca subspecies. Most Klebsiella strains were resistant to the commonly used antimicrobial drugs. However, they were mostly susceptible to aztreonam, amikacin, nalidixic acid and third generation cephalosporins. In conclusion, UTI is common and often asymptomatic in diabetic patients and is mostly caused by a highly resistant species indicating the importance of doing culture and sensitivity to select the most suitable antimicrobial drug for treatment of these patients

value of PCR in the diagnosis of HCV infection in chronic liver disease patients

Hepatitis C virus is a single stranded RNA virus. HCV strains could be grouped into at least 12 genotypes. Diagnosis of HCV infection was made in chronic liver disease patients and the presence of HCV-RNA in the circulation was correlated with the severity of the liver disease in anti- HCV positive chronic liver diseased patients using the polymerase chain reaction [PCR] technique in 159 cases and 50 controls. The prevalence of anti-HCV among the chronic liver disease patients was 83.6% and 38% in the control group. The PCR results were 72.3% in the patient group and 26% in the control group. The percentage of RNA positive cases in the RIBA positive samples was 87.4%. HCV-RNA was present in 89.7% of the cirrhotic patients. ALT level correlated with anti-HCV positivity and there was a significant difference between the patient and control regarding ALT level, 51.6% of the cases in the patient group had elevated ALT and 84.1% of the cases who had elevated ALT were HCV-RNA positive. We concluded that there was a high prevalence of HCV infection among chronic liver disease patients and HCV-RNA was found to correlate with the liver pathology, symptom free HCV infected patients exist and some have normal liver function tests, despite the presence of liver affection which might be severe