PREVALENCE OF URINARY TRACT INFECTION IN DIABETIC PATIENTS ATTENDING UMUAHIA HEALTH CARE FACILITIES

ABSTRACT

Diabetes is a polygenic disease characterized by abnormally high glucose levels in the blood. There is evidence that patients with diabetes have an increased risk of Urinary Tract Infections (UTIs). UTI is the most common bacterial infection in diabetic patients. The study population included diabetic patients and non diabetic patients (attending five different Umuahia Health Care Facilities). Urine culture was carried out on the urine samples collected using MacConkey media. A total of four genera of bacteria were isolated namely; Escherichia coli, Staphylococcus aureus, Klebsiella spp and Pseudomonas spp. 70% of diabetics had positive urine cultures while 56% of non-diabetics had positive urine cultures. The most frequent bacteria isolated was Escherichia coli with a percentage value of 34.28%. The isolated micro-organisms were more sensitive to Gentamycin, Streptomycin and Ciproflox and more resistant to augmentin, ampicillin and ceporex. UTIs are frequent in diabetics, a great proportion of asymptomatic forms exist among diabetic patients therefore urine culture should be performed in all patients with diabetes.

TABLE OF CONTENTS

Certification ﾿ i

Dedication ﾿ ii

Acknowledgement ﾿ iii

Table of Content ﾿ iv

List of Tables ﾿ vi

List of Figures                                                                                                                  vii

Abstract ﾿ viii

CHAPTER ONE ﾿

1.0 ﾿ INTRODUCTION ﾿ 1

1.1 ﾿ Objective of the study ﾿ 3

1.3 ﾿ Scope of study ﾿ 4

CHAPTER TWO ﾿

2.0 ﾿ LITERATURE REVIEW

2.1 ﾿ Definition of urinary tract infection ﾿ 5

2.2 ﾿ Urinary tract infection in diabetic patients ﾿ 5

2.2 ﾿ Route of infection ﾿ 6

2.3 ﾿ Definitions ﾿ 7

2.4 ﾿ Factors contributing to urinary tract infection ﾿ 9

2.4.1 ﾿ Infections beginning in the urinary tract ﾿ 10

2.5 ﾿ Clinical features of urinary tract infection in diabetic patients ﾿ 10

2.5.1 ﾿ General features of UTI ﾿ 11

2.5.2 ﾿ Symptoms and signs of lower UTI ﾿ 11

2.5.3 ﾿ Symptoms of upper UTI ﾿ 12

CHAPTER THREE ﾿

3.0 ﾿ MATERIALS AND METHODS ﾿

3.1 ﾿ Study area ﾿ 13

3.2 ﾿ Study population ﾿ 13

3.3 ﾿ Specimen collection ﾿ 13

3.4 ﾿ Isolation of micro-organisms ﾿ 13

3.5 ﾿ Characterization and identification of isolated micro-organisms ﾿ 13

3.6 ﾿ Gram stain ﾿ 14

3.7 ﾿ Biochemical tests ﾿ 14

3.8 ﾿ Antibiotic sensitivity test ﾿ 17

3.9 ﾿ Statistical analysis ﾿ 18

CHAPTER FOUR ﾿

4.0 ﾿ RESULTS ﾿ 19

CHAPTER FIVE ﾿

5.0 ﾿ DISCUSSION, CONCLUSION AND RECOMMENDATION ﾿

5.1 ﾿ Discussion ﾿ 29

5.2 ﾿ Conclusion ﾿ 30

5.3 ﾿ Recommendation ﾿ 30

REFERENCES

LIST OF TABLES

TABLE                   TITLE                                                                                          PAGE

1  ﾿ Antibiotics for sensitivity test ﾿ 17

2 ﾿ Identification of isolates ﾿ 21

3    ﾿ Frequency of isolated organisms in diabetics compared to non-diabetics ﾿ 22

4    ﾿ Prevalence of organisms isolated from diabetics and non-diabetics ﾿ 23

5    ﾿ Antibiotic Sensitivity/Resistance Profile ﾿ 26

7  ﾿ Antibiotic Sensitivity/Resistance Profile ﾿ 27

Table 8:    ﾿ Antibiotic Sensitivity/Resistance Profile ﾿ 28

LIST OF FIGURES

Fig. 1:    ﾿ Bacteria Isolates Distribution of Diabetic and Non-Diabetic Subject ﾿ 24