Symptomatic And Asymptomatic Bacteriuria And Drug Susceptibility Pattern Of Urinary Tract Infections Among Diabetic Patients Attending At Tikur Anbessa Specialized University Hospital Addis Ababa.

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Background:The risk of developing infection in diabetic patients is higher and urinarytract is the most common site for infection. Urinary tract infection (UTI)may besymptomatic or asymptomatic. The etiology of UTI and the antibiotic resistance ofuropathogens have been changing over the past years. In Ethiopia, there are somepublished informationconcerning community acquired and hospital acquired UTIs, butno study was conducted in asymptomatic bacteriuria and antimicrobial susceptibilitypattern forUTIs in Ethiopian diabetic patients.rnObjective:The aim of the study was to identify the prevalence of symptomatic andasymptomatic bacteriuria, to isolate the bacterial pathogens and determine drugsusceptibility pattern of urinary tract infections among diabetic patients attendingDiabetic referral clinics at Tikur Anbessa Specialized University Hospital,Addis Ababa.rnMethods: A cross sectional survey wasconducted by systematic sampling technique bytaking every other diabetic patient coming to diabetic referral clinics and admitted tomedical wards and medical Intensive Care Unit (ICU). A total of 413 diabeticpatientswere selected during thestudy period from June 2009to August2009.rnResults:Nine (13.6%) of the symptomatic DM patients had bacteriuria compared withthirty six(10.4%) of asymptomatic DM patient.The overall prevalence of UTI in bothgroups was 45(10.9%).The bacterial pathogens isolated were predominantly gramnegative and two isolates were gram positive. Of the gram negative isolates the mostcommon organism was Escherichia coli, 6% and 28% followed by Klebsiellapneumoniae, 2% and 6% in the symptomatic and asymptomatic DM patientsrespectively. The other gram negative organisms found in small numbers werePseudomonasaeruginosa, 1(0.2%) andEnterobacter clocace, 1(0.2%). The only isolatefrom gram positive wasEntrococcusspp.2 (0.5%).rnThe susceptibility testing results of the isolates showed that over 85%Escherichia colistrains were sensitive to ciprofloxacin, Amoxicillin-Clavulanic acid, ceftizadine,nitrofuranton, ceftiraxone, norfloxacin and kanamycin(85.3–94.1%),but there was a higher rate of resistant to both ampicillin (67.6%), tetracycline (64.7%) andTrimethoprim-sulphamethoxazole (64.7%).Klebsiella pneumoniaewere100%sensitiveto ciprofloxacin, ceftazidime, ceftiraxone and over 85% sensitive to gentamycin (87.5%)butshowed a high rate of resistance(75%) to ampicillin, tetracyclin and Trimethoprim-sulphamethoxazole.The frequency of multipleresistancesfor two or more drugs amongthe urinary pathogenswere found in thirty three(71.7%) of the isolates.rnConclusion:The prevalence of urinary tract infection in this study ishigh in women thanmen and also pyuria and glucosuria can be considered as strong association withbacteriuria.Escherichia coli was the most commonbacterial pathogen isolated in bothsymptomatic and asymptomaticbacteriuria.Remarkablyover (60%) of all isolateswereresistances to ampicillin, tetracycline and Trimethoprim-sulphamethoxazolehave beenfound in this study.Therefore, the investigation of bacteriuria in diabetic patients byscreening for urinary tract infection is very important as it enables to treat properly andprevent the development of renal complications and eventually severe renal damage andfailure.

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Symptomatic And Asymptomatic Bacteriuria And Drug Susceptibility Pattern Of Urinary Tract Infections Among Diabetic Patients Attending At Tikur Anbessa Specialized University Hospital Addis Ababa.

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