Dwijen Das1, Kallol Bhattacharjee2, Agrawal Piyush3, Amit Kumar Kalwar4, Giridhari Kar5, Prithwiraj Bhattacharjee6
BACKGROUND
The worldwide prevalence of diabetes has risen dramatically over the past two decades from 30 million cases in 1985 to 382 million in 2013. Infections are of particular concern in diabetics. Benign prostatic hyperplasia and benign prostatic enlargement are the most common diseases in aging men which can lead to lower urinary tract symptoms.
AIMS AND OBJECTIVE
The objective of this study.
1. To study various risk factors associated with Urinary tract infections in Diabetes with prostatomegaly.
2. To study causative microorganisms and their drug susceptibility in diabetics with Urinary tract infections having prostatomegaly.
MATERIALS & METHODS: STUDY SETTING
A hospital based prospective observational study conducted for a period of 1 year. 50 indoor cases meeting inclusion criteria were selected.
INCLUSION CRITERIA
Diabetics having prostatomegaly presenting with urinary tract infection or positive urine culture were included.
RESULTS
Out of 50 patients 46% had bacteriuria, 82% were above 50 years. Longer duration of diabetes >6years were associated with bacteriuria in 59.37% in contrast to <6 years in 22.22% of cases.
Significant higher bacteriuria was seen in group noncompliant to treatment than those of compliant group, 64% vs 28%.
Association of bacteriuria were lower in patients with HbA1C <7% whereas no difference was observed in relation to fasting and postprandial blood sugar levels. Bacteriuric patients also had significantly high post voidal residue >150 ml in contrast to those with <150ml (56.75% vs. 38%) and greater size of prostate volume >40cc in comparison with volume <40 (57.57% vs 23.53%).
E. coli was the commonest organism followed by klebsiella in 56.52% and 17.39% respectively and were sensitive to imipenem, cefepime, aminoglycoside, fluoroquinolones and nitrofurantoin.
CONCLUSION
Urinary tract infection is frequently encountered in diabetics with prostatomegaly. Elderly patients aged >50 years, longer duration of diabetes, non-adherence to treatment, insulin therapy and prostate volume >40cc could be considered as significant risk for bacteriuric urinary infection. Uncontrolled blood glucose with HbA1 C>7%, post void residue >150 ml and prostate volume >40 cc are associated with bacteriuria. E. coli is the commonest organism and imipenem, cefepime, aminoglycosides, fluoroquinolones and nitrofurantoin showed favourable response.
