Asymptomatic urinary tract infections and associated risk factors in diabetes mellitus patients attending a diabetes center of Peshawar, Pakistan

Abstract

Introduction: Type 2 Diabetes patients are at increased risk of urinary tract infections that, if neglected, can result in chronic renal disease and end stage renal failure. Asymptomatic bacteriuria (ASB) is a feature of type 2 diabetics and can be a silent forerunner of future symptomatic urinary tract infections.
Objective: To determine the magnitude of asymptomatic urinary tract infections in type 2 diabetics and investigate possible associated factors.
Materials & Methods: A cross sectional study was conducted at Sugar Hospital and Research Center, Peshawar over 04 months (March to May 2018) on all type 2 diabetic patients presenting during the study period through convenience sampling. A mid-stream urine sample was collected and microscopically examined for leucocytes; a dipstick was used to detect nitrates. All relevant patient information was noted, and a comparison was made between ASB and non ASB groups. Data were analyzed by SPSS 22 for descriptive and comparative statistics, keeping p≤0.05 as significant.
Results: A total of 363 diabetic patients were included, of which 28.6% (n=104) had ASB. Mean age was 50.39±11.74 years, and 63.4% (n=230) were females, of whom 61.7% (n= 223) were stay at home mothers; 54.3% (n=197) had been diabetic for 5-10yrs. The mean HbA1c value was 9.98±2.68, and 27.5% (n=100) were on insulin; 7.7% (n=28) had BMI>30. Complications such as retinopathy and nephropathy were 26.4% (n=96) and 33.9% (n=123) respectively; 26.7% (n=97) of the subjects were hypertensive. A positive association was found between gender, occupation, nephropathy and ASB (p<0.05).
Conclusion: Asymptomatic urinary tract infections were present in a significant number of subjects and showed a positive association with gender, occupation and nephropathy.