Significant asymptomatic bacteriuria among Nigerian type 2 diabetics

Significant asymptomatic bacteriuria is a risk factor for symptomatic urinary infection and septicemia among predisposed individuals such as diabetics. We investigated the pattern of asymptomatic bacteriuria among our type 2 diabetics with a view to documenting the prevalence, type of organisms responsible and the antibiotic susceptibility pattern. One hundred and twenty-four type 2 Nigerian diabetics (55 males and 69 females) submitted midstream urine specimens for culture. Thirty-three patients had significant bacteriuria (9 males and 24 females), showing the frequency of occurrence of asymptomatic bacteriuria to be 26.6%. The most common organism isolated was Klebsiella pneumonia at 42.4%. Gram-negative bacilli made up about 23 (69.7%) of the isolates. Isolates were poorly sensitive to the readily available antibiotics (ampicillin, tetracycline and cotrimoxazole), but a large number of the organisms isolated were sensitive to nitrofurantoin, gentamicin, ciprofloxacin and ofloxacin. Sensitivity to erythromycin, nalidixic acid and cefuroxime was moderate. Asymptomatic bacteriuria is, thus, more prevalent among the Nigerian diabetic population than in the non-diabetics. A changing pattern of disease is observed with Klebsiella sp. now accounting for the majority of asymptomatic bacteriuria among diabetics. The organisms are not sensitive to the commonly available antibacterial agents.