Skip to content
1887

Journal of Medical Microbiology logo Journal of Medical Microbiology

Volume 74, Issue 1

Prevalence, aetiology and antimicrobial resistance profile of diabetic individuals suffering from community-acquired urinary tract infection No Access

Abstract

The rise in antimicrobial resistance poses a significant threat to global health, particularly among diabetic patients who are prone to urinary tract infections (UTIs).

Pathogens that cause UTI among diabetic patients exhibit significant multidrug resistance (MDR) patterns, necessitating more precise empirical treatment strategies.

. This study aimed to determine the prevalence of UTI among diabetic patients and study the antimicrobial susceptibility profiles of uropathogens, detected and identified the potential differences in age groups and between genders, focusing on MDR and gender-based variations, causing a global concern in deciding empirical treatment.

A prospective study was conducted from August 2021 to December 2023 in Gujarat, India. During the period, 1023 diabetic patients with symptoms of UTI were diagnosed by urine culture and 280 individuals tested positive for UTIs. Antibiotic susceptibility testing was carried out on these 280 micro-organism isolates.

Among the 280 UTI-positive patients, 166 (59.29%) were females and 114 (40.71%) were males, with the prevalence of UTI in diabetic females being 27.34% (166/607) and males being 27.40% (114/416). Among the isolated uropathogens, (56.78%) was the predominant organism followed by (13.57%) and (13.21%). High resistance was noted to various antibiotics in Gram-negative bacteria including both genders. In , resistance was predominantly high against the penicillin sub-class of the beta-lactam group (70.23%, 69.58%), cephalosporins (66.23%, 76.52%) and least against nitrofurans (30.10%, 40%) in males and females, respectively. has shown higher resistance to cephalosporins (66.23%, 76.52%) and aminoglycosides (60.92%, 62.66%) and least resistance to carbapenem (41.67%) and phosphonic (33.33%) in males and females, respectively. A high proportion of isolates, ~82.5%, exhibited MDR. Among these MDR isolates, those from female patients accounted for a higher percentage (58.44%) compared with males (41.55%). The highest prevalence of MDR was observed in the 41–60-year age group. This pattern highlights notable differences in MDR prevalence across gender and age groups.

The high prevalence of UTI caused by MDR organisms based on gender and age group highlights the need for clinicians to choose antibiotics more judiciously for empirical treatment, thereby reducing misuse and overuse in the community. For diabetic UTI patients in this region, nitrofurantoin may be recommended for uncomplicated cases due to low resistance in , while fosfomycin could be a viable alternative for -related infections. Carbapenems may be reserved for severe cases with MDR pathogens, and combination therapy could be considered for complicated infections, particularly in high-risk age groups.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): antimicrobial resistance , diabetes mellitus , multidrug resistance , urinary tract infection and uropathogen
© 2025 The Authors
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001962
2025-01-28
2026-02-19

Metrics

Loading full text...

Full text loading...

References

  1. Flores-Mireles A, Hreha TN, Hunstad DA. Pathophysiology, Treatment, and Prevention of Catheter-Associated Urinary Tract Infection. Top Spinal Cord Inj Rehabil 2019; 25:228–240 [View Article] [PubMed]
     [Google Scholar]
  2. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon 2003; 49:71–82 [View Article] [PubMed]
     [Google Scholar]
  3. Belyayeva M, Leslie SW, Jeong JM. Acute pyelonephritis. Treasure Island 20241–22
     [Google Scholar]
  4. Sabih A, Leslie SW. Complicated urinary tract infections. Treasure Island 20241–23
     [Google Scholar]
  5. Al-Badr A, Al-Shaikh G. Recurrent urinary tract infections management in women: a review. Sultan Qaboos Univ Med J 2013; 13:359–367 [View Article] [PubMed]
     [Google Scholar]
  6. Bischoff S, Walter T, Gerigk M, Ebert M, Vogelmann R. Empiric antibiotic therapy in urinary tract infection in patients with risk factors for antibiotic resistance in a German emergency department. BMC Infect Dis 2018; 18:56 [View Article] [PubMed]
     [Google Scholar]
  7. Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol 2019; 11:1756287219832172 [View Article] [PubMed]
     [Google Scholar]
  8. Ronald AR, Nicolle LE, Stamm E, Krieger J, Warren J et al. Urinary tract infection in adults: research priorities and strategies. Int J Antimicrob Agents 2001; 17:343–348 [View Article] [PubMed]
     [Google Scholar]
  9. Alghoraibi H, Asidan A, Aljawaied R, Almukhayzim R, Alsaydan A et al. Recurrent urinary tract infection in adult patients, risk factors, and efficacy of low dose prophylactic antibiotics therapy. J Epidemiol Glob Health 2023; 13:200–211 [View Article]
     [Google Scholar]
  10. Bader MS, Loeb M, Leto D, Brooks AA. Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents. Postgrad Med 2020; 132:234–250 [View Article] [PubMed]
     [Google Scholar]
  11. Sotto A, De Boever CM, Fabbro-Peray P, Gouby A, Sirot D et al. Risk factors for antibiotic-resistant Escherichia coli isolated from hospitalized patients with urinary tract infections: a prospective study. J Clin Microbiol 2001; 39:438–444 [View Article] [PubMed]
     [Google Scholar]
  12. Ahmed H, Farewell D, Jones HM, Francis NA, Paranjothy S et al. Incidence and antibiotic prescribing for clinically diagnosed urinary tract infection in older adults in UK primary care, 2004-2014. PLoS One 2018; 13:e0190521 [View Article] [PubMed]
     [Google Scholar]
  13. Magiorakos A, Srinivasan A, Carey RB, Carmeli Y, Falagas ME et al. Bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2011; 18:268–281 [View Article]
     [Google Scholar]
  14. Lichtenberger P, Hooton TM. Complicated urinary tract infections. Curr Infect Dis Rep 2008; 10:499–504 [View Article] [PubMed]
     [Google Scholar]
  15. Schiff MA, Holt VL. Pregnancy outcomes following hospitalization for motor vehicle crashes in Washington State from 1989 to 2001. Am J Epidemiol 2005; 161:503–510 [View Article] [PubMed]
     [Google Scholar]
  16. Ahmed AE, Abdelkarim S, Zenida M, Baiti MAH, Alhazmi AAY et al. Prevalence and associated risk factors of urinary tract infection among diabetic patients: a cross-sectional study. Healthcare 2023; 11:861 [View Article]
     [Google Scholar]
  17. Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in J N M C Hospital Aligarh, India. Ann Clin Microbiol Antimicrob 2007; 6:1–7 [View Article]
     [Google Scholar]
  18. Keah SH, Wee EC, Chng KS, Keah KC. Antimicrobial susceptibility of community-acquired uropathogens in general practice. Malaysian Fam Physician 2007; 2:64–69
     [Google Scholar]
  19. Hima-Lerible H, Ménard D, Talarmin A. Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in Bangui, Central African Republic [11]. J Antimicrob Chemother 2003; 51:192–194 [View Article] [PubMed]
     [Google Scholar]
  20. Dias Neto JA, Martins ACP, Silva LDM da, Tiraboschi RB, Domingos ALA et al. Community acquired urinary tract infection: etiology and bacterial susceptibility. Acta Cir Bras 2003; 18:33–36 [View Article]
     [Google Scholar]
  21. Lee AC, Mullany LC, Koffi AK, Rafiqullah I, Khanam R et al. Urinary tract infections in pregnancy in a rural population of Bangladesh: population-based prevalence, risk factors, etiology, and antibiotic resistance. BMC Pregnancy Childbirth 2019; 20:1 [View Article] [PubMed]
     [Google Scholar]
  22. Gupta S, Kapur S, Padmavathi D. Comparative prevalence of antimicrobial resistance in community-acquired urinary tract infection cases from representative States of northern and southern India. J Clin Diagn Res 2014; 8:DC09–12 [View Article] [PubMed]
     [Google Scholar]
  23. Larsson M, Kronvall G, Thi Kim Chuc N, Karlsson I, Lager F et al. Antibiotic medication and bacterial resistance to antibiotics: a survey of children in a Vietnamese community. Tropical Med Int Health 2000; 5:711–721 [View Article]
     [Google Scholar]
  24. Ahmed SS, Shariq A, Alsalloom AA, Babikir IH, Alhomoud BN. Uropathogens and their antimicrobial resistance patterns: relationship with urinary tract infections. Int J Health Sci (Qassim) 2019; 13:48–55 [PubMed]
     [Google Scholar]
  25. Awasthi TR, Pant ND, Dahal PR. Prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection among the patients attending outpatient department of Seti Zonal Hospital, Dhangadi, Nepal. Nepal J Biotechnol 2015; 3:55–59 [View Article]
     [Google Scholar]
  26. Bagir G, Haydardedeoglu F, Colakoglu S, Bakiner O, Ozsahin K et al. Urinary tract infection in diabetes: susceptible organisms and antibiogram patterns in an outpatient clinic of a tertiary health care center. Med-Sci 2019; 8:881 [View Article]
     [Google Scholar]
  27. Baral P, Neupane S, Marasini BP, Ghimire KR, Lekhak B et al. High prevalence of multidrug resistance in bacterial uropathogens from Kathmandu, Nepal. BMC Res Notes 2012; 5:38 [View Article]
     [Google Scholar]
  28. Sohail M, Khurshid M, Saleem HGM, Javed H, Khan AA. Characteristics and antibiotic resistance of urinary tract pathogens isolated from Punjab, Pakistan. Jundishapur J Microbiol 2015; 8:e19272 [View Article] [PubMed]
     [Google Scholar]
  29. Rahman S, Ahmed M, Begum A. Occurrence of Urinary Tract Infection in Adolescent and Adult Women of Shanty Town in Dhaka City, Bangladesh. Ethiop J Health Sci 2014; 24:145 [View Article]
     [Google Scholar]
  30. Vinod CSS, Nareddy VA, Nagabhushana MV. A clinical study of urinary tract infections in diabetics and non-diabetics patients. Int J Adv Med 2019; 6:1421 [View Article]
     [Google Scholar]
  31. Nicolle LE. Complicated urinary tract infection in adults. Can J Infect Dis Med Microbiol 2005; 16:349–360 [View Article] [PubMed]
     [Google Scholar]
  32. Lipsky BA. Urinary Tract Infections in Men. Ann Intern Med 1989; 110:138 [View Article]
     [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.001962
Loading
Prevalence, aetiology and antimicrobial resistance profile of diabetic individuals suffering from community-acquired urinary tract infection
J. Med. Microbiol. 74, 001962 (2025); https://doi.org/10.1099/jmm.0.001962
/content/journal/jmm/10.1099/jmm.0.001962
/content/journal/jmm/10.1099/jmm.0.001962
Loading

Data & Media loading...

Supplements

Supplementary material 1

EXCEL

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An error occurred
Approval was partially successful, following selected items could not be processed due to error