Detection of Asymptomatic Bacteriuria and Antimicrobial Susceptibility Testing among Diabetic Patients in Khartoum State

Abstract

Abstract: Background: Urinary tract infections (UTIs) are one of the most common infections seen in all age groups with diabetes mellitus (DM). The term asymptomatic bacteriuria (ASB) refers to the isolation of bacteria in a urine specimen of individuals with unobserved symptoms of UTIs. DM is one of the risk factors of UTIs and causes complications including renal abscess, cystitis, fungal infections, pyelonephritis, and renal papillary necrosis. Objectives: This study aimed to detect asymptomatic bacteriuria and antimicrobial susceptibility patterns for isolated organisms among adult, asymptomatic diabetic patients were attended selected diabetic hospitals and centers in Khartoum state. Methods: A descriptive, prospective cross-sectional study was conducted on 120 asymptomatic diabetic patients from July to October 2022 in Khartoum state, Sudan. Information about patient demographics and clinical status was obtained from each patient using a written questionnaire. Clean-catch midstream urine specimens were collected and cultured on CLED, then processed for isolation and identification of uropathogens through conventional microbiological procedures. Antibiotic susceptibility patterns were determined by using the Kirby-Bauer disc diffusion method through culturing the isolates on Mueller- Hinton agar. The collected data and laboratory results were analyzed using SPSS version 26. Results: 120 asymptomatic diabetic patients were included in this study, the age -mean was 44.8±11.76, out of which 16.7% (n=20/120) showed significant ASB and 75% (n=15/20) of them were females. In this study, there was a significant association between the level of HbA1c (P. value 0.049), bacteriuria (P. value 0.000), and ASB among studied diabetic patients, on the other hand, no significant association between age, gender, or type of DM, duration of DM, recurrent UTIs, other study variables and ASB. S. aureus was the commonest isolated uropathogen (40%) followed by P. aeruginosa (25%), E. coli (15%), E. faecalis (15%), C. koseri (5%), S. aureus isolates were resistant to oxacillin in (62%). The isolated organisms were resistant to cefotaxime (50%), gentamycin (50%), imipenem (35%), nalidixic acid (75%) ciprofloxacin (40%). Conclusion: The overall prevalence of ASB among asymptomatic diabetic patients was high (16.7%). In this study poor glycemic control is a significant risk factor for ASB. Regular screening for ASB through culture and antimicrobial susceptibility testing is recommended mainly for females over 45 years. Keywords: Bacteriuria, Diabetic Patients, Asymptomatic, Antimicrobial Susceptibility Testing, Sudan.