A study of clinico-microbiological profile and outcome of urinary tract infection in diabetic kidney disease in a tertiary care hospital

Abdullah; Syed Hasan Amir; Mohd Aslam; Khwaja Saifullah Zafar

doi:10.18203/2320-6012.ijrms20232096

Authors

Abdullah Department of Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India
Syed Hasan Amir Department of Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India
Mohd Aslam Department of Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India
Khwaja Saifullah Zafar Department of Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232096

Keywords:

Clinicomicrobiological, DKD, UTI

Abstract

Background: this study was done to give insight about the clinical and microbiological profile of UTI in DKD and its therapeutic outcome.

Methods: Patient known case of DKD presenting with signs and symptoms of UTI were included in study. Patients known case of diabetes having diabetic retinopathy and albuminuria with at least UACR of >30 mg/gm of creatinine were considered as having DKD.

Results: We found, most common presenting symptom was fever, present among 35 (47.29%) patients followed by increased frequency of urination among 30 (40.54%) patients. Burning micturition and dysuria/flank pain was present among 20 (27.02%) patients and 10 (13.51%) patients respectively, lower abdominal pain in 08 (10.81%) patients. 52 (70.27%) patients’ culture were sterile and 22 (29.73%) patients’ culture were non-sterile. Out of 22 patients of non-sterile cultures, 16 (72.72%) patients have lower UTI compared to 06 (27.27%) patients with Upper UTI. E. coli was the most common organism cultured in both types of UTIs. Fungal growth (Candida tropicalis) was seen in 03 (50%) patient, all were cases of upper UTI.

Conclusions: The clinical and microbiological profile of UTI in DKD doesn’t differ from UTI in diabetics and non-diabetics except for prolonged and severe course of disease. The microbiological susceptibility also doesn’t differ much. Lower age is associated with lower UTI. Upper urinary tract involvement is associated significantly with progression of CKD. Involvement of upper urinary tract should be sought in UTI in diabetics and patient with DKD and if found should be aggressively treated.

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References

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157:107843.

de Boer IH, Rue TC, Hall YN, Heagerty PJ, Weiss NS, Himmelfarb J. Temporal trends in the prevalence of diabetic kidney disease in the United States. JAMA. 2011;305(24):2532-9.

Saran R, Li Y, Robinson B, Abbott KC, Agodoa LY, Ayanian J, et al. US Renal Data System 2015 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2016;67(3 suppl 1):Svii,S1-305.

Reutens AT. Epidemiology of diabetic kidney disease. Med Clin North Am. 2013;97:1-18.

USRDS: the United States Renal Data System. Am J Kidney Dis. 2003;42:1-230.

Stamm WE, Norrby SR. Urinary tract infections: disease panorama and challenges. J Infect Dis. 2001;183(1):S1-4.

Neal DE. Host defence mechanisms in urinary tract infections. Urol Clin North Am. 1999;26:677-86,vii.

Khan IH, Catto GR. Long-term complications of dialysis: infection. Kidney Int. 1993;41:S143-8.

Kessler M, Hoen B, Mayeux D, Hestin D, Fontenaille C. Bacteremia in patients on chronic hemodialysis. A multicenter prospective survey. Nephron. 1993;64:95-100.

Chiu PF, Huang CH, Liou HH, Wu CL, Wang SC, Chang CC. Long-term renal outcomes of episodic urinary tract infection in diabetic patients. J Diabetes Complicat. 2013;27(1):41-3.

Shankar M, Narasimhappa S, Madhura NS. Urinary tract infection in chronic kidney disease population: a clinical observational study. Cureus. 2021;13(1).

Jagadeeswaran G, Ansari MZ, Rajangam T. Urinary tract infection in diabetics- a five year retrospective study on the prevalence of bacterial isolates and its antibiotic susceptibility patterns in a tertiary care hospital in South India. Int J Contemp Med Res. 2018;5:D33-8.

Hsiao CY, Lin HL, Lin YK, Chen CW, Cheng YC, Lee WC, et al. Urinary tract infection in patients with chronic kidney disease. Turk J Med Sci. 2014;44(1):145-9.

Arjumand M, Ali GM, Dutta PK, Hassan MH, Hasan KM, Barua BK. Pattern of UTI in Chronic Kidney Disease: Experience from A Tertiary Care Hospital, Bangladesh. Chattagram Maa-O-Shishu Hosp Med Coll J. 2021;20(1):41-5.

Ullah A, Lim SI. Plant extract‐based synthesis of metallic nanomaterials, their applications, and safety concerns. Biotech Bioengin. 2022;119(9):2273-304.

Kumar R, Kumar R, Perswani P, Taimur M, Shah A, Shaukat F. Clinical and microbiological profile of urinary tract infections in diabetic versus non-diabetic individuals. Cureus. 2019;11(8).

Gilbert DN. Urinary tract infections in patients with chronic renal insufficiency. Clin J Am Soc Nephrol. 2006;1(2):327-31.