Asymptomatic bacteriuria in patients with diabetes mellitus

ABSTRACT

The study was carried on 300 cases to assess the rate of asymptomatic bacteriuria in patients with diabetes mellitus. Cases were grouped into three groups. The first group included 100 diabetic patients with diabetic complications. The second group included 100 diabetic patients without diabetic complications. A third group included 100 non diabetic apparently healthy persons as a control group. 34% of complicated diabetics [group [I]] and 25% of uncomplicated diabetics [group [II]] had significant bacteriuria. While only 12% of the control group had significant bacteriuria compared with 29.5% of the two diabetic groups. There was significant difference in pyuria between the diabetic group and the control group [6.5% and 1% respectively]. The association between bacteriuria and pyuria was highly significant in all studied groups. Also there was significant difference as regards the significant bacteriuria between each studied group in females [54%, 36%, and 18% for complicated, uncomplicated and control group respectively], While the difference between each group in males was insignificant [14%, 14%, and 6%]. Organisms causing asymptomatic bacteriuria were aerobic in 85.3% of group [I], 96% in group [II] and 100% in control persons. The anaerobic organisms were detected in the remaining of diabetic cases. The difference between the three studied groups as regards isolated organisms is insignificant. E. coli was the prevalent causative agent of significant bacteriuria in all studied groups [47% in group [I], 48% in group [II], and 50% in controls]. The isolated aerobic organisms was significantly higher than anaerobic organisms. Urine specimens were examined by direct immuofluorescence test for detection of antibody coated bacteria [IF-A CB]. ACB was detected in 32.4% of complicated diabetic patients and 12% of uncomplicated diabetics, with significant bacteriuria. The rate of significant bacteriuria was found to increase with the age of patients and the duration of diabetes especially the complicated one, but not with degree of control of diabetes