Ciprofloxacin is not a better choice in the patients with diabetes suffering urinary tract infection

Yıl 2019, Cilt: 46 Sayı: 1, 65 - 72, 03.03.2019

Kader Ugur İsa Ahmet Bal Ayse Sagmak Tartar Nevzat Gozel Bedrettin Orhan Emir Donder Abdullah Mubin Ozercan

https://doi.org/10.5798/dicletip.474694

Cited By: 2

Öz

Objective:
The aim of this study is to determine antibacterial susceptibilities of
Gram-negative bacteria isolated from diabetic and non-diabetic patients as
infectious agents of community-acquired urinary tract infections (UTI) and to
compare their rates of resistance to the antibiotics frequently used in
empirical treatment.

Methods:
Ninety-six diabetic and sixty-eight non-diabetic (total n=164) patients’ data
were evaluated retrospectively who diagnosed as community-acquired urinary
system infection and consulted to outpatient clinics of Department of
Endocrinology and Infectious Diseases of Firat University School of Medicine
between January 1st , 2014 and December 31st, 2014 whose urine cultures
demonstrated Gram-negative bacteria were included in the study. Antibiotic
susceptibilities of the isolated bacteria were determined using Vitek 2
automated system and the results were evaluated as sensitive and resistant.

Results: In
both diabetic and non-diabetic patient groups, most frequently Escherichia coli
(88.5% in diabetic and 85.3% in non-diabetic groups) were isolated. In the
diabetic group, microorganisms mostly demonstrated the highest rates of
resistance against ampicillin, cephalosporins, ciprofloxacin,
amoxicillin-clavulanic acid and in the non-diabetic group ampicillin,
amoxicillin-clavulanic acid, cefuroxime and trimethoprim-sulfamethoxazole.

Conclusion:
Resistance to ciprofloxacin was at a significantly higher rate in the diabetic
group. In diabetic patients, it will be more appropriate to give antibiotherapy
in urinary system infections based on the antibacterial susceptibility test
results.

Anahtar Kelimeler

Diabetes mellitus, urinary tract infection

Kaynakça

• 1. International Diabetes Federation. Diabetes Atlas. 6th edition, update 2014. http://www.idf.org/diabetes atlas
• 2. Simkhada R. Urinary tract infection and antibiotic sensitivity pattern among diabetics. Nepal Med Coll J. 2013; 15 :1-4.
• 3. Yu S, Fu AZ, Qiu Y, et al. Disease burden of urinary tract infections among type 2 diabetes mellitus patients in the US. J Diabetes Complications 2014; 28 :621–6.
• 4. Wang MC, Tseng CC, Wu AB, et al. Bacterial characteristics and glycemic control in diabetic patients with Escherichia coli urinary tract infection. J Microbiol Immunol Infect 2013; 46 :24-9.
• 5. Sewify M, Nair S, Warsame S, et al. Prevalence of Urinary Tract Infection and Antimicrobial Susceptibility among Diabetic Patients with Controlled and Uncontrolled Glycemia in Kuwait. J Diabetes Res. 2016; 6573215.
• 6. Rawat V, Singhai M, Kumar A, et al. Bacteriological and resistance profile in isolates from diabetic patients. N Am J Med Sci. 2012; 4 :563-8.
• 7. Nitzan O, Elias M, Chazan B, et al. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes Metab Syndr Obes 2015; 8: 129-36.
• 8. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2015; 38: 1-93.
• 9. Catry B, Latour K, Bruyndonckx R, et al. Characteristics of the antibiotic regimen that affect antimicrobial resistance in urinary pathogens. Antimicrob Resist Infect Control. 2018; 7: 76.
• 10. Kahlmeter G, Poulsen HO. Antimicrobial susceptibility of Escherichia coli from community-acquired urinary tract infections in Europe: the ECO.SENS study revisited. Int J Antimicrob Agents 2012; 39: 45-51.
• 11. Tsakiridou E, Makris D, Chatzipantazi V, et al. Diabetes and hemoglobin a1c as risk factors for nosocomial infections in critically ill patients. Crit Care Res Pract. 2013: 279479.
• 12. Aswani SM, Chandrashekar UK, Shivashankara KN et al. Clinical profile of urinary tract infections in diabetics and non-diabetics. Australasian Medical Journal 2014; 7: 29-34.
• 13. Fünfstück R, Nicolle LE, Hanefeld M, et al. Urinary tract infection in patients with diabetes mellitus. Clin Nephrol 2012; 77 :40-8.
• 14. Geerlings S, Fonseca V, Castro-Diaz D, et al. Genital and urinary tract infections in diabetes: impact of pharmacologically-induced glucosuria. Diabetes Res Clin Pract. 2014; 103 :373-81.
• 15. Hirji I, Guo Z, Anderrson S.W, et al. Incidence of urinary tract infection among patients with type 2 diabetes in the UK General Practice Research Database 2012; 26: 513-6.
• 16. Hammar N, Farahmand B, Gran M, et al. Incidence of urinary tract infection in patients with type 2 diabetes. Experience from adverse event reporting in clinical trials. Pharmacoepidemiol Drug Saf 2010; 19: 1287-92.
• 17. Akhtar MS, Mohsin N, Zahak A, et al. Antimicrobial sensitivity pattern of bacterial pathogens in urinary tract infections in South Delhi, India. Rev Recent Clin Trials. 2014; 9 :271-5.
• 18. Choe HS, Lee SJ, Cho YH, et al.; GPIU Asian Investigators. Aspects of urinary tract infections and antimicrobial resistance in hospitalized urology patients in Asia: 10-Year results of the Global Prevalence Study of Infections in Urology (GPIU). J Infect Chemother 2018; 24 :278-83.
• 19. Naz H, Cevik FC, Aykın N. Hastane kökenli üriner sistem infeksiyonları ve antibiyotik direnç profili. Dicle Med J 2009; 36: 85-90.
• 20. Fasugba O, Gardner A, Mitchell BG, et al. Ciprofloxacin resistance in community-and hospital-acquired Escherichia coli urinary tract infections: a systematic review and meta-analtsis of observational studies.BMC Infectious Diseases 2015; 15: 545-60.
• 21. Frei CR, Labreche MJ, Attridge RT. Fluoroguinolones in community-acguired pneumonia: guide to selection and appropiate use. Drugs 2011; 71: 757-70.
• 22. Cıkman A, Gundem NS, Gulhan B, et al. İdrar kültürlerinden soyutlanan Enterobacteriaceae türlerinin GSBL üretimi ile ertapenem ve diğer antibiyotiklere direncinin belirlenmesi. Dicle Med J. 2014; 41 :474-8.
• 23. Ijaz M, Khan SM, Hassan M, Bangash IH. Urinary tract infection in diabetic patients; causative bacteria and antibiotic sensitivity J. Med. Sci. 2014; 22 :110-4.
• 24. Erden S, Çalangu S. Poliklinik hastalarında üriner sistem infeksiyonlarından izole edilen Escherichia coli suşlarının çeşitli antibiyotiklere in vitro duyarlılıkları. İstanbul Tıp Fakültesi Mecmuası 2002; 65: 147-9.
• 25. Redgrave LS, Sutton SB, Webber MA, Piddock LJ. Fluoroquinolone resistance: mechanisms, impact on bacteria, and role inevolutionary success. Trends Microbiol. 2014; 22 :438-45.
• 26. Kim ES, Hooper DC.Clinical importance and epidemiology of quinolone resistance. Infect Chemother. 2014; 46: 641-6.
• 27. Aral M, Kireçci E, Doğan SŞ. İdrar örneklerinden izole edilen gram negatif bakteriler ve antibiyotiklere direnç oranlarının retrospektif olarak değerlendirilmesi. Türk Mikrobiyoloji Cemiyeti Derg 2011; 41: 139-42.
• 28. Gangcuangco LM, Alejandria M, Henson KE, et al. Prevalence and risk factors for trimethoprim-sulfamethoxazole-resistant Escherichia coli among women with acute uncomplicated urinary tract infection in a developing country. Int J Infect Dis 2015; 34: 55-60.
• 29. Vinken JEM, Mol HE, Verheij TJM, et al. Antimicrobial resistance in women with urinary tract infection in primary care: No relation with type 2 diabetes mellitus. Prim Care Diabetes. 2018; 12 :80-6.
• 30. Yismaw G, Asrat D, Woldemanuel Y, et al. Urinary tract ınfection: Bacterial etiologies, drug resistance profile and associated risk factors in diabetic patients attending Gondar University Hospital, Gondar, Ethiopia. European Journal of Experimental Biology 2012; 2: 889-98.