Bacterial and Drug Susceptibility Profiles of Urinary Tract Infection in Diabetes Mellitus Patients at Mbarara Regional Referral Hospital, Uganda

Abstract

Aim: The risk of developing infection in diabetic mellitus patients is known to be higher than in normal individuals. The urinary tract is the most common entry point of infections. Surveillance of urinary tract pathogens and their antibiogram is key to patient management. The main objective of this study is to determine the prevalence of bacterial causative agents of urinary tract infections and their antibiogram in diabetes mellitus patients. Methods and Materials: A hospital - laboratory based cross-sectional study was conducted from February to April 2014. A total of 105 asymptomatic and symptomatic diabetes patients (55 females and 50 males) that consented were recruited in the study. Mid stream urine samples were obtained for standard culture on CLED agar. Bacterial colonies were subjected to Gram stain and relevant biochemical tests were used for isolate identification and antibiogram determined using Kirby bauer disc diffusion method.   Results: Significant bacteriuria (≥105 Colonies/mL) was detected in 13.3% (14/105) of the participants. The common causative agents were Escherichia coli (50%), Klebsiella pneumoniae (28.6%), Staphylococcus aureus (14.3%) and unidentified coliform (7.1%). Majority of the isolates showed 92.9% and 85.7% sensitivity to Gentamicin and Ceftriaxone respectively but a relatively low susceptibility of 64.3% to ciprofloxacin and resistance of 78.6%, and 64.3% against co-trimoxazole and Ampicillin respectively.  Conclusion: Significant bacteriuria was obtained as 13.3% and Escherichia coli (50%) as was the highest uropathogen. Isolates showed high resistance to Co-trimoxazole (78.6%) and ampicillin (64.3%). The isolation of bacterial pathogens that resist the commonly prescribed drugs calls for an early screening of all diabetes mellitus patients with urinary tract infections.