The Role of Prognostic Nutritional Index in UTI Susceptibility Among Female Type 2 Diabetic Patients

Compared with individuals without diabetes, patients with diabetes have a higher susceptibility to urinary tract infection (UTI), and the infection is often more severe. Women are particularly vulnerable compared with men. This study attempted to explore predicted indicators and risk factors of the occurrence of UTI in women with Type 2 diabetes mellitus (T2DM).

The aim of this study is to identify bacterial distribution and antimicrobial resistance patterns and to assess clinical risk factors for UTI in women with T2DM.

A retrospective study was carried out on 136 patients with diabetes mellitus hospitalized in the Endocrinology Department of Taizhou Central Hospital (Taizhou University Hospital). The levels of fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), hemoglobin, peripheral blood leukocyte count, neutrophil count, monocyte count, C-reactive protein, and urine pH were collected. Demographic data, physical examination data, and medical history were also collected. Urine culture was performed using the Autof ms1000, while antimicrobial susceptibility testing was conducted with the VITEK 2.

One hundred thirty-six patients aged 60.49 ± 13.02 years old were enrolled in our study, and a total of 30 patients had positive urine cultures. Height, marital status, HbA1c, FBG, prognostic nutritional index (PNI), urine pH, and peripheral blood leucocyte-to-monocyte ratio were associated with UTI (p < 0.05). Multivariable logistic regression analysis showed that marital status (odds ratio = 6.33, 95%CI = [1.06 ~ 37.82], p = 0.043), FBG (odds ratio = 1.26, 95%CI = [1.08 ~ 1.46], p = 0.004), and PNI (odds ratio = 0.89, 95%CI = [0.81 ~ 0.99], p = 0.025) were the influencing factors for UTI. Escherichia coli (14/30, 46.7%) was the most common pathogen, and the susceptibility rate of levofloxacin to E. coli was low (1/14, 7.1%).

The levels of PNI, FBG, and marital status were identified as risk factors for UTI in women with T2DM. E. coli was the most common causative agent.