Prevalence of Urinary Tract Infections and Their Antimicrobial Sensitivity Among Diabetic and Non Diabetic Patients in Zakho
DOI:
https://doi.org/10.25271/sjuoz.2019.7.4.629Keywords:
Urinary Tract Infections, Diabetes Mellitus, Susceptibility, Pyuria, SuperantigensAbstract
Urinary tract infection (UTI) is one of the most common bacterial infections in diabetics and non-diabetics. Worldwide about one hundred fifty million people are infected with UTI each year. Indifference in diabetes management has been shown to increase the risk of complications. This may lead to different microbial infections including UTI. UTI is often treated with various broad-spectrum antibiotics due to concerns about infection with resistant organisms. The aim of this study was to determine the prevalence of UTI and antibiotic sensitivity pattern in both diabetic and non-diabetic patients attended the Zakho Emergency Hospital and Chamiskho Health Center at refugee camp in Zakho city. Midstream urine sample was collected from 316 patients attended Zakho Emergency Hospital and Chamiskho Health Center from September 2018 to January 2019 in Zakho city. 316 samples were collected from diabetic and non-diabetics, 195 (61.70%) sample were collected from diabetics and 121 (38.30%) sample were collected from non-diabetic patients. The frequency of male and female was 101 (31.96%) and 215 (68.04%) respectively. The top five dominant bacteria isolated in this study were Escherichia coli (43.20%), Klebsiella pneumoniae (19.90%), Proteus mirabilis (11.65%), Pseudomonas aeruginosa (8.73%) and Staphylococcus aureus (6.31%). The isolated bacteria were highly sensitive to meropenem (100%) followed by imipenem (97% sensitive) and less sensitive to ciprofloxacine, amikacin and nitrofurantoin. While most of the isolates were resistance to tetracycline (21% sensitive), ampicillin (22% sensitive) and piperacillin (28% sensitive). Analysis of the results showed that urinary tract infection is more prevalence in diabetic than non-diabetics and in female than male. Also, the most commonly isolated bacterium was E. coli. Most isolated pathogens show high resistance to tetracycline and ampicillin.
References
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Al-Daghistani, H. I., & Abdel-Dayem, M. (2002). Diagnostic value of various urine tests in the Jordanian population with urinary tract infection. Clinical chemistry and laboratory medicine, 40(10), 1048-1051.
Al-Rubeaan, K. A., Moharram, O., Al-Naqeb, D., Hassan, A., & Rafiullah, M. (2013). Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes. World journal of urology, 31(3), 573-578.
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Angoti, G., Goudarzi, H., Hajizadeh, M., & Tabatabaii, Z. (2016). Bacteria isolated from urinary tract infection among patients and determination of the antibiotic susceptibility patterns of the gram negative bacteria in Iran. Novelty in Biomedicine, 4(1), 1-4.
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Arsalan B., Zafer K., Özlem Yuksel E., İbrahim Halil B., Tansu D., Tarik Y., Bülent G. (2014). Pathogen Bacteria of the Urinary Tract Isolated from Urine Cultures and Their Susceptability.The American journal of medicine, 80(2), 208-214.
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Epp, A., Larochelle, A., Lovatsis, D., Walter, J.-E., Easton, W., Farrell, S. A., Robert, M. (2010). Recurrent urinary tract infection. Journal of Obstetrics and Gynaecology Canada, 32(11), 1082-1090.
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Javed, N., Ali, F. A., Subhani, H., & Manzur, F. (2015). Study of Bacteria isolated from Urinary Tract Infections and to Determine their Susceptibility for Antibiotics at a Teaching Hospital. PAKISTAN JOURNAL OF MEDICAL & HEALTH SCIENCES, 9(2), 557-560.
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Mansoor, I. Y., AL-Otraqchi, K. I., & Saeed, C. H. (2015). Prevalence of urinary tract infections and antibiotics susceptibility pattern among infants and young children in Erbil city. Zanco Journal of Medical Sciences, 19(1), 915-922.
Marti, A., Moreno-Aliaga, M., Hebebrand, J., & Martinez, J. (1998). Alberti KGM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complication. Diabet Med, 15, 539-553.
Mueller, T., Resinger, C., Ruffingshofer, D., Arbeiter, K., Balzar, E., & Aufricht, C. (2003). Urinary tract infections beyond the early post-transplant period in pediatric renal graft recipients. Wiener Klinische Wochenschrift, 115(11), 385-388.
Nicolle, L. E. (2000). Asymptomatic bacteriuria in diabetic women. Diabetes care, 23(6), 722-722.
Okada, H., Sakai, Y., Miyazaki, S., Arakawa, S., Hamaguchi, Y., & Kamidono, S. (2000). Detection of significant bacteriuria by automated urinalysis using flow cytometry. Journal of clinical microbiology, 38(8), 2870-2872.
Okada, H., Shirakawa, T., Gotoh, A., Kamiyama, Y., Muto, S., Ide, H., Horie, S. (2006). Enumeration of bacterial cell numbers and detection of significant bacteriuria by use of a new flow cytometry-based device. Journal of clinical microbiology, 44(10), 3596-3599.
Patterson, J. E., & Andriole, V. T. (1997). Bacterial urinary tract infections in diabetes. Infectious Disease Clinics, 11(3), 735-750.
Polse, R., Yousif, S., & Assafi, M. (2016). Prevalence and antimicrobial susceptibility patterns of uropathogenic E. coli among people in Zakho, Iraq. International Journal of Research in Medical Sciences, 4(4), 1219-1223.
Schlievert, P. M., Salgado-Pabón, W., & Klingelhutz, A. J. (2015). Does Staphylococcus aureus have a role in the development of Type 2 diabetes mellitus? : Future Medicine.
Sewify, M., Nair, S., Warsame, S., Murad, M., Alhubail, A., Behbehani, K., Tiss, A. (2016). Prevalence of urinary tract infection and antimicrobial susceptibility among diabetic patients with controlled and uncontrolled glycemia in Kuwait. Journal of diabetes research, 2016.
Sokal, R. R. and Rohlf, F. J. (2009). Introduction to biostatistics, 2nd ed. Dover .New York, 1099-1121.
Tektook, N. K., Al-Lehibi, K. I., & Al-Husseinei, R. K. (2017). Prevalence Some Pathogenic Bacteria Causing UTI in Diabetic Patients In/Specialized Center For Endocrinology and Diabetes of Baghdad City–Iraq. Medical Journal of Babylon, 14(2), 260-266.
Unachukwu, C., Obunge, O., & Odia, O. (2005). The bacteriology of diabetic foot ulcers in Port Harcourt, Nigeria. Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria, 14(2), 173-176.
Wayne, P. (2011). Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing.
YÜRÜYEN, C., GÜROL, Y., KALEAĞASIOĞLU, S. F., KASPAR, E. Ç., & YILMAZ, G. (2017). Isolation rates and antibiotic susceptibilities of different Enterobacteriaceae species as urinary tract infection agents in Turkey: a systematic review. Turkish journal of medical sciences, 47(3), 979-986.
Zhanel, G. G., Nicolle, L. E., & Harding, G. K. (1995). Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. Clinical infectious diseases, 21(2), 316-322.
Al-Berfkani, M. I., Allu, M. A., & Mousa, S. A. (2016). The effect of climate temperature and daily water intake on the diversity of uropathogens causing urinary tract infections in adult hospital patients. Diyala Journal of Medicine, 11(1), 62-69.
Al-Daghistani, H. I., & Abdel-Dayem, M. (2002). Diagnostic value of various urine tests in the Jordanian population with urinary tract infection. Clinical chemistry and laboratory medicine, 40(10), 1048-1051.
Al-Rubeaan, K. A., Moharram, O., Al-Naqeb, D., Hassan, A., & Rafiullah, M. (2013). Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes. World journal of urology, 31(3), 573-578.
Alhamdany, M. H. A. (2018). Antibiotic susceptibility of bacteria isolated from patients with diabetes mellitus and recurrent urinary tract infections in Babylon Province, Iraq. Medical Journal of Babylon, 15(1), 63-68.
Alsohaili, S. A., Alharahsheh, M. H., Almshagbeh, M. A., Alkhawaldeh, R. A., & ALkhawaldeh, W. M. (2015). Bacterial pathogen in urinary tract infection and antibiotic resistance patteern in Zaraqa-Jordan. European Scientific Journal, 11(12).
Angoti, G., Goudarzi, H., Hajizadeh, M., & Tabatabaii, Z. (2016). Bacteria isolated from urinary tract infection among patients and determination of the antibiotic susceptibility patterns of the gram negative bacteria in Iran. Novelty in Biomedicine, 4(1), 1-4.
Boscia, J. A., Kobasa, W. D., Knight, R. A., Abrutyn, E., Levison, M. E., & Kaye, D. (1986). Epidemiology of bacteriuria in an elderly ambulatory population. Medicine journal, 36(1), 29-34.
Arsalan B., Zafer K., Özlem Yuksel E., İbrahim Halil B., Tansu D., Tarik Y., Bülent G. (2014). Pathogen Bacteria of the Urinary Tract Isolated from Urine Cultures and Their Susceptability.The American journal of medicine, 80(2), 208-214.
Douri, F. E. (2008). Prevalence of silent bacteriuria in patients with diabetes mellitus. Iraqi Academic Scientific Journal, 7(1), 60-64.
Epp, A., Larochelle, A., Lovatsis, D., Walter, J.-E., Easton, W., Farrell, S. A., Robert, M. (2010). Recurrent urinary tract infection. Journal of Obstetrics and Gynaecology Canada, 32(11), 1082-1090.
Feleke, Y., Mengistu, Y., & Enquselassie, F. (2007). Diabetic infections: clinical and bacteriological study at Tikur Anbessa Specialized University Hospital, Addis Ababa, Ethiopia. Ethiopian medical journal, 45(2), 171-179.
Geerlings, S. E., Stolk, R. P., Camps, M., Netten, P. M., Hoekstra, J., Bouter, K. P., Hoepelman, A. (2000). Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes care, 23(6), 744-749.
Gul, M., Kurutas, E., Ciragil, P., Cetinkaya, A., Kilinc, M., Aral, M., & Buyukbese, M. A. (2005). Urinary tract infection aggravates oxidative stress in diabetic patients. The Tohoku journal of experimental medicine, 206(1), 1-6.
Gupta, K., Hooton, T. M., & Stamm, W. E. (2001). Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Annals of internal medicine, 135(1), 41-50.
Hadi, A. M., Sheri, F. H., & Jaccob, A. A. (2014). Urinary tract infection prevalence and antibiotic resistance a retrospective study in Basra governorate, Iraq. Al-Mustansiriyah Journal of Pharmaceutical Sciences (AJPS), 14(2), 129-135.
Hvidberg, H., Struve, C., Krogfelt, K. A., Christensen, N., Rasmussen, S. N., & Frimodt-Møller, N. (2000). Development of a long-term ascending urinary tract infection mouse model for antibiotic treatment studies. Antimicrobial agents and chemotherapy, 44(1), 156-163.
Javed, N., Ali, F. A., Subhani, H., & Manzur, F. (2015). Study of Bacteria isolated from Urinary Tract Infections and to Determine their Susceptibility for Antibiotics at a Teaching Hospital. PAKISTAN JOURNAL OF MEDICAL & HEALTH SCIENCES, 9(2), 557-560.
Kunin, C. M. (1979). Detection, prevention, and management of urinary tract infections (Vol. 381): Lea & Febiger Philadelphia.
Lewis, D. (1989). Bacteriology of urine in: Medical microbiology a partial approach. a Practical Approach, pp. 1-19. Edited by P. M. Hawkey& D. Lewis. Oxford:IRL Press.
Liza, D., & Jonathan, O. (2006). Urinary Tract Infections: Causes, Symptoms and Treatment. Am. J. Epidemol, 132, 328-337.
Mansoor, I. Y., AL-Otraqchi, K. I., & Saeed, C. H. (2015). Prevalence of urinary tract infections and antibiotics susceptibility pattern among infants and young children in Erbil city. Zanco Journal of Medical Sciences, 19(1), 915-922.
Marti, A., Moreno-Aliaga, M., Hebebrand, J., & Martinez, J. (1998). Alberti KGM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complication. Diabet Med, 15, 539-553.
Mueller, T., Resinger, C., Ruffingshofer, D., Arbeiter, K., Balzar, E., & Aufricht, C. (2003). Urinary tract infections beyond the early post-transplant period in pediatric renal graft recipients. Wiener Klinische Wochenschrift, 115(11), 385-388.
Nicolle, L. E. (2000). Asymptomatic bacteriuria in diabetic women. Diabetes care, 23(6), 722-722.
Okada, H., Sakai, Y., Miyazaki, S., Arakawa, S., Hamaguchi, Y., & Kamidono, S. (2000). Detection of significant bacteriuria by automated urinalysis using flow cytometry. Journal of clinical microbiology, 38(8), 2870-2872.
Okada, H., Shirakawa, T., Gotoh, A., Kamiyama, Y., Muto, S., Ide, H., Horie, S. (2006). Enumeration of bacterial cell numbers and detection of significant bacteriuria by use of a new flow cytometry-based device. Journal of clinical microbiology, 44(10), 3596-3599.
Patterson, J. E., & Andriole, V. T. (1997). Bacterial urinary tract infections in diabetes. Infectious Disease Clinics, 11(3), 735-750.
Polse, R., Yousif, S., & Assafi, M. (2016). Prevalence and antimicrobial susceptibility patterns of uropathogenic E. coli among people in Zakho, Iraq. International Journal of Research in Medical Sciences, 4(4), 1219-1223.
Schlievert, P. M., Salgado-Pabón, W., & Klingelhutz, A. J. (2015). Does Staphylococcus aureus have a role in the development of Type 2 diabetes mellitus? : Future Medicine.
Sewify, M., Nair, S., Warsame, S., Murad, M., Alhubail, A., Behbehani, K., Tiss, A. (2016). Prevalence of urinary tract infection and antimicrobial susceptibility among diabetic patients with controlled and uncontrolled glycemia in Kuwait. Journal of diabetes research, 2016.
Sokal, R. R. and Rohlf, F. J. (2009). Introduction to biostatistics, 2nd ed. Dover .New York, 1099-1121.
Tektook, N. K., Al-Lehibi, K. I., & Al-Husseinei, R. K. (2017). Prevalence Some Pathogenic Bacteria Causing UTI in Diabetic Patients In/Specialized Center For Endocrinology and Diabetes of Baghdad City–Iraq. Medical Journal of Babylon, 14(2), 260-266.
Unachukwu, C., Obunge, O., & Odia, O. (2005). The bacteriology of diabetic foot ulcers in Port Harcourt, Nigeria. Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria, 14(2), 173-176.
Wayne, P. (2011). Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing.
YÜRÜYEN, C., GÜROL, Y., KALEAĞASIOĞLU, S. F., KASPAR, E. Ç., & YILMAZ, G. (2017). Isolation rates and antibiotic susceptibilities of different Enterobacteriaceae species as urinary tract infection agents in Turkey: a systematic review. Turkish journal of medical sciences, 47(3), 979-986.
Zhanel, G. G., Nicolle, L. E., & Harding, G. K. (1995). Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. Clinical infectious diseases, 21(2), 316-322.
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2019-12-30
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Jameel, A. Y., & Artoshi, D. M. (2019). Prevalence of Urinary Tract Infections and Their Antimicrobial Sensitivity Among Diabetic and Non Diabetic Patients in Zakho. Science Journal of University of Zakho, 7(4), 125–131. https://doi.org/10.25271/sjuoz.2019.7.4.629
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