Asymptomatic and symptomatic bacteriuria in patients with type 2 diabetes

Aim: Asymptomatic bacteriuria (ASB) and symptomatic bacteriuria with antibiotic‑resistant organisms are common in patients with type 2 diabetes. The aim was to study the prevalence, bacterial profile and antibiotic susceptibility pattern in ASB and symptomatic bacteriuria and the factors associated with Escherichia coli bacteriuria in type 2 diabetes. Materials and Methods: This was an observational case‑control study done on 400 asymptomatic type 2 diabetes patients, 200 symptomatic urinary tract infection (UTI), and 200 nondiabetic controls. Various clinical, biochemical parameters and urine examination and culture were studied. Results: The prevalence of ASB and symptomatic bacteriuria in type 2 diabetes was 17.5% and 69%, respectively, and were significantly higher as compared to controls (10%). E. coli was present in 52.9% of ASB cases of type 2 diabetes and 70% of nondiabetic control ASB. E. coli (55%) was most commonly isolated in symptomatic bacteriuria. Majority of the Gram‑negative bacteria isolates in ASB and symptomatic bacteriuria with type 2 diabetes and controls were sensitive to amikacin, imipenem, piperacillin/tazobactam, and nitrofurantoin. E. coli were more resistant to quinolones in ASB and symptomatic bacteriuria than controls. Most of the Gram‑positive bacteria were sensitive to vancomycin, linezolid, and amoxiclav. The factors associated with E. coli bacteriuria in type 2 diabetes were female gender, long duration of diabetes, past history of symptomatic UTI, poor glycemic control, and renal function. Conclusions: E. coli remains the most common isolated microorganism in asymptomatic and symptomatic bacteriuria. E. coli were more resistant to quinolones in patients with type 2 diabetes.