Endocrine Abstracts

Introduction: Urinary tract infection is worrying in diabetic patients especially unbalanced. Contracting a multidrug-resistant bacterium is even more alarming since it narrows the therapeutic means in a patient whose immune system is already weakened by the diabetes. The objective of this study is to describe the clinical and metabolic characteristics of a population of diabetic patients with urinary tract infection.

Methods: This is a retrospective study that included 46 diabetic patients with a urinary tract infection, hospitalised in the A Department of Diabetes and Nutrition at the National Institute of Nutrition in Tunis for ketoacidosis decompensation of their diabetes.

Results: The mean age was 46.4±10.2 years. The sex ratio was 0.02. Diabetes was type 2 in 100% of cases, evolving since 23.4±6.1 years on average. The average body mass index (BMI) was 33.2±5.6 kg/m². 13% were smokers. All patients were poorly balanced with a mean HbA1C of 10.6±1.7%. The mean creatinine clearance was 99.2±10.8 ml/min. 13.6% had dyslipidemia. 17.39% were hypertensive. None of these cases of urinary truct infection were complicated. The proportion of multidrug-resistant infections was quite high at 15.21%. 89.13% of these infections were in Escherichia Coli. The most prescribed antibiotics were third-generation cephalosporins in more than 90% of cases. The subpopulation infected with multidrug-resistant bacterias was characterized by a later response for resuscitation of ketoacidosis.

Conclusion: Diabetes is one of the most common factors that increases vulnerability to infections, especially urinary tract infections. The problem is now more complicated by the emergence of resistant bacterias, which can be life-threatening. The balance of diabetes and the rational use of antibiotics are the main means of combating this problem.