Risk factors and etiological characteristics of urinary tract infection in type 2 diabetes mellitus / 中国糖尿病杂志

ABSTRACT

Objective To explore the risk factors for urinary tract infections in type 2 diabetes mellitus(T2DM )by analyzing the pathogens distribution characteristics and drug sensitivity. Methods A total of 3 ,065 T2DM patients were retrospectively analyzed for the clinical and etiological characteristics of urinary tract infections in T2DM. All patients enrolled in the study were divided into two groupsT2DM with urinary tract infection group (n= 210) and simple T2DM group (n= 132). Data harvested were analyzed by SPSS 19.0. Results Of 3 ,065 patients with T2DM the incidence of urinary tract infection was 6.85%. Compared with T2DM group ,patients in T2DM+ urinary tract infection group were older , with longer duration of diabetes ,higher levels of FPG ,urea nitrogen ,creatinine and 24 hUAlb ,and lower levels of serum albumin ( P< 0.05 ). Logistic regression analysis showed that age ,gender ,duration of diabetes and 24 hUAlb were risk factors and albumin was protective factor for urinary tract infection in T2DM. 84.2% was gram-negative bacteria among the 210 isolated strains of pathogenic bacteria. The top three pathogens were Escherichia coli (65.2% ) ,Enterococcus faecalis (6.2% ) and Klebsiella pneumoniae (5.2% ). Gram-negative bacteria had high sensitivity to Imipenem (100% ) ,Cefoperazone sulbactam (99.2% ) and Amikacin (99.2% ) but low sensitivity to cephalothin (38.1% ) ,piperacillin (35.7% ) and amoxicillin (28.2% ). Conclusion T2DM patients who have the factors including female ,advanced age , long course of diabetes and renal insufficiency are prone to suffer from urinary tract infection. Gram-negative bacteria are the most common pathogens in T 2DM patients with urinary tract infection but bacteria spectrum has changed with percentage of multiple resistant bacteria rising dramatically.