Study On Cases Of Urinary Tract Infections In Patients With Type 2 Diabetes Mellitus : Pathogenesis And Results Of Drug Sensitive Test

Objective:To examine clinical features,pathogenic bacterias and their tolerance to antibiotics of urinary tract infections in patients with type 2 diabetes mellitus(T2DMUTI) and find out the discrimination between ones without diabetes mellitus(DM).Methods:Urinary tract infections(UTI) in patients with or without T2DM which belonged to The Second Affiliated Hospital of Chongqing Medical University were obtained through Medical Case Inquiry System. Informations were collected and analyzed including clinical features,pathogenesis and results of drug sensitive test to show the differences between cases with or without T2DM.Results:1 Clinical features:T2DMUTI had more elder patients(t=8.179,P<0.001)and longer in charging days(t=2.916,P=0.004)than UTI.Females had a higher ratio in patients with or without T2DM than males,however,male ratio were higher in T2DMUTI compared with UTI(X~2=8.648,P =0.003). The followlling itms were found with higher rates in T2DMUTI than UTI: ASB rate(X~2=38.252,P<0.001) and antibiotic combining rate(X~2=16.674,P<0.001).2 Constituent ratio of main pathogenic bacterias: The most frequent causative organisms of bacteriuria was Escherichia coli(E. coli). Extended spectrumβ-lactamases(ESBLs)ratio of T2DMUTI was higher than UTI(X~2=5.886,P=0.015)T2DMUTI had higher rates of fungal infection(X~2=6.027,P=0.014)and gram positive coccus(GPC) (X~2=6.636,P=0.010)compared with UTI.3 The outcome of drug sensitive test pertaining to E. coli:It displayed that Imipenem(IPM) and Meropenem(MEC) were the most sensitive antibiotics. T2DMUTI had higher drug resistant rates of ampicillin(AMP)(X~2=4.663,P=0.031),tobramycin(TOB)(X~2=9.591,P=0.002),gatifloxacin(GAT)(X~2=8.546,P=0.003),Amoxicillin-Clavulanic Acid(AMC)(X~2=22.763,P<0.001),furantoin(NIT()X~2=4.231,P=0.040)and Piperacillin-Tazobactam(TZP)(X~2=16.175,P<0.001)compared with UTI, but cefepime(FEP)(X~2=3.919,P=0.048)was lower.Conclusion:The males with T2DM were eaiser to encounter UTI than males without T2DM. ASB and fungal or GPC infections were more prevailing in T2DMUTI.The pathogenic bacterias causing T2DMUTI had a wider antimicrobial resistant profile and more severe drug resistant trend.The therapy of T2DMUTI was intractable and combined medication was recommended.