GROSS PYURIC DIABETICS WITH UNCONTROLLED GLYCEMIA: PATTERN OF PATHOGENIC ORGANISMS AND ANTIMICROBIAL SUSCEPTIBILITY

OBJECTIVES: To determine the frequency of microbiologically confirmed urinary tract infection (UTI), pattern of causative organisms and their antimicrobial susceptibility in uncontrolled diabetic patients with gross pyuria. METHODS: This study was conducted at Department of Medicine, Divisional Headquarter Hospital KDA Kohat and Qazi Medical Centre, Kohat- Pakistan, from January 2015 to December 2015. Ninty six adult diabetic patients having uncontrolled glycemia (Random blood sugar 200mg/dl) with gross pyuria ( 100 pus cell/HPF on urinalysis) and not taking any antibiotic for the last 3 days were enrolled in study. Urine of patients was sent for culture and sensitivity. RESULTS: Out of 96 patients, 88 (91.66%) were having Type 2 Diabetes Mellitus and 8 (8.33%) had Type 1 Diabetes Mellitus. Patients were ranging in age from 19-70 years with mean age of 51.156±12.54 years. Out of 96 tested urine samples, 80 (83.33%) were with positive urine culture report while in 16 (16.67%) cases no significant growth of any microorganism was obtained. Out of these 80 positive cases, E.Coli was the most frequent isolate in 68 (85%) samples followed by Proteus in 7 (8.75%) samples. Isolated E.Coli showed 100% sensitivity to Piperacillin plus Tazobactum and Imipinem but 100% resistance was observed to Naladixic Acid, Norfloxacin and Ciprofloxacin. CONCLUSION: Diagnostic yield of urine culture and sensitivity in uncontrolled diabetic patients with gross pyuria was 83.33%. Escherichia coli were found to be the most predominant isolate, showing high drug resistance particularly to naladixic acid, ciprofloxacin and norfloxacin.