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Urinary tract infection in patients with diabetes mellitus

I M Hoepelman1

  • 1Dept. of Medicine, Section Clinical Immunology & Infections Disease and Eijkman-Winkler Laboratory for Medical Microbiology, P.O. Box 85500, 3508 GA Utrecht, Netherlands.

International Journal of Antimicrobial Agents
|June 1, 1994
PubMed

Insights

Diabetics have higher rates of urinary tract infections (UTIs), even without symptoms. Increased bacterial adherence to urinary cells is the likely cause, requiring complicated UTI treatment.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Endocrinology

Background:

  • Urinary tract infections (UTIs) are common in patients with diabetes mellitus.
  • UTIs in diabetics can range from asymptomatic bacteriuria to severe kidney infections.
  • Diabetic patients exhibit higher prevalence of asymptomatic bacteriuria, particularly women.

Purpose of the Study:

  • To investigate the increased susceptibility to UTIs in patients with diabetes mellitus.
  • To explore the underlying mechanisms contributing to higher UTI rates in diabetics.
  • To establish optimal treatment guidelines for UTIs in diabetic patients.

Main Methods:

  • Review of existing literature on UTIs in diabetes mellitus.
  • Analysis of pathogen prevalence in diabetic patients with UTIs.
  • Evaluation of proposed mechanisms for increased UTI susceptibility.

Main Results:

  • Common UTI pathogens in diabetics are similar to those in complicated UTIs.
  • Potential mechanisms include "sweet urine" effect, neutrophil dysfunction, and increased bacterial adherence.
  • Increased adherence to uroephitelial cells is considered the most probable cause.

Conclusions:

  • Diabetic patients are at increased risk for UTIs, often involving the kidneys.
  • Treatment for UTIs in diabetics should be considered complicated.
  • Therapy should involve agents with high tissue levels for 10-14 days.

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