Prevalence and Antibiotic Resistance Pattern of Urinary Tract Infection in Diabetic Patients in Pakistan

Abstract

Objective: To determine the prevalence of urinary tract infection (UTI) and pattern of antibiotic resistance among diabetic patients in Pakistan.

Materials and methods: The cross-sectional study was done, which included 320 diabetic patients aged greater than 18 years. Patients with symptomatic or asymptomatic UTI were recruited from UOL Hospital over the interval of eight months. To analyze the urine samples, standard microbiological methods were used. Clinical and Laboratory Standards Institute (CSI) guidelines were taken into account. Statistical significance was checked with logistic regression. Data was analyzed using SPSS and chi-square.

Result: A study of 320 diabetic patients found a high prevalence of urinary tract infections (UTIs), particularly among females (47.5% vs. 19.2% in males; p < 0.001) and those with uncontrolled glycemia (48.3% vs. 25.7% in controlled patients; p < 0.001). Escherichia coli (51.5%) and Klebsiella pneumoniae (24.6%) were the dominant uropathogens. Notably, all six ESBL-producing E. coli isolates occurred in uncontrolled diabetics (p = 0.003). Antimicrobial resistance was high against trimethoprim-sulfamethoxazole (46.8%) and ciprofloxacin (38.2%), while nitrofurantoin (8.5% resistance) and amikacin (4.1%) remained effective, supporting nitrofurantoin as a safer first-line option in this population.

Conclusion: The frequent occurrence of UTIs and high antimicrobial resistance among diabetic patients emphasizes the need for culture-guided antibiotic treatment along with effective glycemic control to manage infections successfully.