Asymptomatic bacteriuria among diabetics attending Kenyatta National Hospital

Significant asymptomatic bacteriuria is an important cause of pyelonephritis and gram negative septicaemia among certain predisposed individuals, such as diabetics. We investigated the incidence of asymptomatic urinary tract infections (UTIs) among our diabetic patients and the type and antibacterial sensitivity patterns of the organisms causing these UTIs. One hundred and thirty five patients submitted midstream urine specimens for culture. Fifteen patients had positive cultures showing the incidence of asymptomatic UTI to be 11.1%. There were ten female and five male patients with UTI. The commonest organism isolated was Escherichia coli at 40%. Gram negative bacilli made up 66.7% of the isolates. Isolates were poorly sensitive to the regularly available antibiotics-ampicillin (33% sensitive, cotrimoxazole (33% sensitive). Nitrofurantoin inhibited growth in 93% of the isolates. Other antimicrobials with over 80% sensitivity level included: gentamicin, ceftazidime, augmentin, cefuroxime and norfloxacin. They are expensive or require parenteral administration. The incidence of asymptomatic UTI is high among diabetics and although the organisms isolated are those usually isolated in UTIs, they are not that sensitive to the commonly available and antibacterial agents.