Bacterial Etiologies, Antimicrobial Susceptibility Patterns and Associated Risk Factors of Urinary Tract Infection among Diabetic Patients Attending Diabetic Clinics in Harar, Eastern Ethiopia

Abstract

Background: People with Diabetes Mellitus or problems with the body’s natural defense mechanism are more likely to get Urinary Tract Infections (UTIs). The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of the types of organisms that cause the disease and the selection of an effective antibiotic against the organism in question.
Objective: To assess the prevalence of urinary tract infections, antimicrobial susceptibility patterns and associated risk factors among diabetic patients in Harar, Eastern Ethiopia.
Methods: A facility-based cross-sectional study was conducted among diabetic patients visiting diabetic clinics of five hospitals in Harar town from July 2014 to September, 2014. A structured questionnaire was used for collection of data on socio-demographic and associated risk factors. Mid-stream clean catch urine samples were collected using sterile containers. Culture and antimicrobial susceptibility testing were performed using the standard protocol. The data was entered into Epi-data version 3.15 and analyzed using SPSS version 16. Multivariate logistic regression analysis was conducted to determine the presence of an association between variables using odds ratio with 95% confident intervals and association was declared at P-value <0.05.
Results: A total of 240 diabetic patients participated in this study. Of these 95 (39.6%) of them presented with symptomatic urinary tract infection and the remaining 145 (60.4%) were asymptomatic. Significant bacteriuria was detected in 20% (19/95) and 12.4% (18/145) of symptomatic and asymptomatic diabetic patients respectively. The overall prevalence of urinary tract infection was 15.4% (37/240). The majority of the isolates (70 %) were Gram-negative bacteria. The most frequently isolated bacteria was Escherichia coli (45%) followed by Coagulase-Negative Staphylococci (15 %) and Pseudomonas aeruginosa (10.3%). All bacterial isolates were resistant to at least one antibiotic, and 92.5% of the isolates were resistant to multiple drugs. Previous history of urinary tract infections and female sex were significantly associated with urinary tract infection.
Conclusion: The prevalence of urinary tract infections among diabetic patients attending diabetic clinics in Harar is relative higher when compared to the findings of other studies conducted in different parts of the country and most of the isolates were resistant to multiple antimicrobial agents. Treatment of urinary tract infection among diabetic patients should be based on the result of culture and antimicrobial sensitivity tests.