Open AccessUrinary Tract Infection due to Extended-spectrum Beta-lactamase Producing Organisms is a Risk Factor for Bacteraemia Among Patients with Type 2 Diabetes Mellitus
Author(s) -
Muhammad Abdur Rahim,
Shahana Zaman,
Ishrat Jahan,
Samira Humaira Habib,
Tabassum Samad,
Tufayel Ahmed Chowdhury,
Shudhanshu Kumar Saha,
Abdul Latif,
Mohammad Mehfuz E Khoda,
Mostarshid Billah,
Mehruba Alam Ananna,
Sarwar Iqbal
Publication year - 2019
Publication title -
bangladesh journal of medicine
Language(s) - English
Resource type - Journals
eISSN - 2408-8366
pISSN - 1023-1986
DOI - 10.3329/bjm.v31i1.44747
Subject(s) - medicine , risk factor , etiology , urinary system , diabetes mellitus , type 2 diabetes mellitus , klebsiella pneumoniae , bacteremia , type 2 diabetes , antibiotics , microbiology and biotechnology , endocrinology , escherichia coli , biology , biochemistry , gene
Urinary tract infection (UTI) is common among patients with diabetes mellitus and the aetiological agents are often extended-spectrum beta-lactamase (ESBL) producing bacteria. Diabetic patients with UTI are sometimes complicated by bacteraemia. This study was designed to evaluate whether UTI due to ESBL-positive organisms is a risk factor for bacteraemia among patients with type 2 diabetes mellitus.
Methods: This was a cross-sectional analytical study, done in BIRDEM General Hospital, Dhaka, Bangladesh from January to April 2016. Adult (e”18 years) type 2 diabetic subjects of either sex with culture proven UTI were included in this study. All study participants were subjected to undergo blood cultures as well. ESBL-positivity of the infective organisms for UTI was evaluated as possible risk factor for bacteraemia.
Results: Total patients were 145 including 119 (82%) females. Eshcerichia coli (112, 77.2%) was the most common aetiological agents followed by Klebsiella pneumoniae (28, 19.3%). In 54 (37.2%) patients UTI was due to ESBL-positive organisms. Ten (6.9%) patients were complicated by bacteraemia [7 (7/ 54, 13%) among patients with UTI due to ESBL-positive organisms and 3 (3/91, 3.3%) among patients with UTI due to non-ESBL organisms]. UTI due to ESBL-positive organisms appeared as a significant risk factor for bacteraemia (OR 4.37, 95% CI 1.08-17.38, p 0.03).
Conclusion: Nearly two-fifths of UTI cases were due to ESBL-positive organisms in this study. ESBLpositivity of the causative organisms was a significant risk factor for bacteraemia among type 2 diabetic subjects.
Bangladesh J Medicine Jan 2020; 31(1) : 9-12