Hospital Admissions and Antimicrobial Resistance Patterns in Diabetic Patients With Urinary Tract Infections: A...

Background Diabetes mellitus is a global public health challenge, significantly increasing susceptibility to infections, particularly urinary tract infections (UTIs). Diabetic patients face a higher risk of recurrent and complicated UTIs due to impaired immune function, poor glycemic control, and associated comorbidities. Objective This study aimed to determine the frequency and demographic trends of hospital admissions in diabetic patients suffering from urinary tract infections, identify associated clinical risk factors, evaluate the microbiological profile of uropathogens, and assess prevailing patterns of antimicrobial resistance. Methodology This cross-sectional study was conducted at Gulab Devi Hospital, Lahore, from 1st January 2025 to 30th June 2025. A total of 325 diabetic patients admitted with suspected UTIs were included using non-probability consecutive sampling. Demographic, clinical, and laboratory data were collected. Midstream urine samples were cultured to identify pathogens, and antimicrobial susceptibility was tested using the disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results Among 325 participants, 205 patients (63.1%) had culture-confirmed UTIs. The mean age of UTI-positive patients was 59.2 ± 9.8 years, significantly higher than non-UTI patients (55.8 ± 11.3 years; p = 0.01). Age over 60 years was present in 129 (62.9%) UTI cases. Poor glycemic control (HbA1c >8%) was found in 162 (79.0%) UTI patients, and 152 (74.1%) had diabetes duration exceeding 10 years. Hypertension was reported in 148 (72.2%) and diabetic nephropathy in 67 (32.7%) UTI patients. Escherichia coli was the predominant pathogen in 117 (57.1%) cases, followed by Klebsiella pneumoniae in 37 (18.0%) cases. High resistance rates were seen for amoxicillin in 154 (75.1%) and cotrimoxazole in 139 (67.8%) isolates, while nitrofurantoin and ceftriaxone demonstrated high sensitivity in 174 (84.9%) and 166 (81.0%) cases, respectively. Conclusion It is concluded that urinary tract infections are a common and serious cause of hospital admissions in diabetic patients, particularly those with advanced age, poor glycemic control, and long-standing diabetes. Escherichia coli remains the predominant pathogen with evolving antimicrobial resistance trends.