Résumé
Background: Diabetic subjects, especially women, show high prevalence of asymptomatic bacteriuria (ASB). The aim of the present study was to evaluate the prevalence of asymptomatic bacteriuria (ASB) in patients with type 2 diabetes mellitus and to find out the antibiotic sensitivity pattern of bacterial isolates. Methods: One hundred and thirty type 2 diabetics comprising 56 males and 74 females (aged between 30 - 59 years) attending the outpatient department of Chhattisgarh Institute of Medical sciences hospital, Chhattisgarh, India was recruited in the study. Mid-stream urines were collected from patients aseptically into sterile wide mouth container and examined microscopically, culturally using standard techniques and tested for glucose, post-prandial glucose, protein and ketone using a dipstick. Samples were cultured on blood agar, McConkey agar and Cysteine Lactose Electrolyte Deficient (CLED) media and incubated at 37°C aerobically for 24 h. Isolates were tested against antibiotics which included tetracycline, chloramphenicol, ciprofloxacin and cotrimoxazole by the disc diffusion method. Results: Significant bacteriuria was observed in Forty-seven (36.15%) of urine samples (34 females and 13 males) . Bacteria isolated included Escherichia coli (56.9%), Enterobacter sp. (12.7%), Klebsiella pneumoniae (8.5%) and Proteus sp. (6.3%). E. coli, Enterobacter sp. K. pneumoniae, S. aureus and Proteus sp. were most sensitive to cotrimazaxole, amoxicillin, nalidixic acid and ciprofloxacin but a large number of bacteria were resistant to tetracycline, chloramphenicol and ampicillin. Conclusion: Screening for ASB is necessary in diabetic patients especially if pyuria is detected in urine analysis since ASB has been found to be a risk factor for developing symptomatic urinary tract infection.
Résumé
A 40 year old lady presented with the classical clinical features of Addison's disease which on further investigations with an ultrasound abdomen showed a right suprarenal mass. This was subjected to a fine needle aspiration which revealed pus which on culture grew Klebsiella pneumoniae. Patient responded well to steroids and antibiotics. To the best of our knowledge this is the first report of Klebsiella pneumoniae in association with Addison's disease.