Original Article

Evaluating Association between Glycosylated Hemoglobin and the Spectrum and Antibiotic Resistance of Uropathogens: A Cross Sectional Study

Abstract

Background: Antimicrobial resistance among uropathogens causing community-acquired urinary tract infections (UTIs) is a worldwide concern. It has been suggested that diabetes could be a possible cause of antibiotic resistance. This study was undertaken to identify the responsible microbial culprits for UTI in patients with different range of glycosylated hemoglobin (HbA1C) and evaluate their corresponding resistance pattern.
Methods: TIn a cross-sectional study between 2013 to 2018, data related to the urine culture and sensitivity of patients who had bacteriuria were gathered. For patients with positive urine culture, HbA1C was requested and correlations between HbA1C level with microorganism and its susceptibility were evaluated.
Results: In total, 121 patients were recruited. All study participants were female. The mean age of the patients was 50.2 ± 22.5 (range 19-96). All study participants were of the same race. Fifteen (12.4%) out of 121 patients were diabetics. There were no difference between bacteriology of UTIs in diabetic and nondiabetic patients with the preponderance being caused by E. coli and other gramnegative organisms but, there were positive association between HbA1C and resistance to Nalidixic acid and Gentamicin.
Conclusion: Our study supports the findings that diabetes in itself could be a possible cause of antibiotic resistance to some antimicrobial agents.

1. Sistanizad M, Kouchek M, Miri M, Goharani R, Solouki M, Ayazkhoo L, et al. Carbapenem Restriction and its Effect on Bacterial Resistance in an Intensive Care unit of a Teaching Hospital. Iran J Pharm Res. 2013;12(3):503-9.
2. Alavi-Moghadam M, Miri M, Mokhtari M, Kouchek M, Goharani R, Sistanzad M, et al. Incidence of imipenem-resistant Acinetobacter baumannii in a general intensive care unit (ICU). Caspian journal of internal medicine. 2014;5(3):186-7.
3. Lo E, Nicolle LE, Coffin SE, Gould C, Maragakis LL, Meddings J, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35 Suppl 2:S32-47.
4. Valerius NH, Eff C, Hansen NE, Karle H, Nerup J, Soeberg B, et al. Neutrophil and lymphocyte function in patients with diabetes mellitus. Acta Med Scand. 1982;211(6):463-7.
5. Funfstuck R, Nicolle LE, Hanefeld M, Naber KG. Urinary tract infection in patients with diabetes mellitus. Clinical nephrology. 2012;77(1):40-8.
6. Gupta K, Hooton TM, Stamm WE. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med. 2001;135(1):41-50.
7. Gangcuangco LM, Alejandria M, Henson KE, Alfaraz L, Ata RM, Lopez M, et al. Prevalence and risk factors for trimethoprim–sulfamethoxazole-resistant Escherichia coli among women with acute uncomplicated urinary tract infection in a developing country. International Journal of Infectious Diseases. 2015;34:55-60.
8. Steinke DT, Seaton RA, Phillips G, MacDonald TM, Davey PG. Factors associated with trimethoprim-resistant bacteria isolated from urine samples. J Antimicrob Chemother. 1999;43(6):841-3.
9. Velasco M, Horcajada JP, Mensa J, Moreno-Martinez A, Vila J, Martinez JA, et al. Decreased invasive capacity of quinolone-resistant Escherichia coli in patients with urinary tract infections. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2001;33(10):1682-6.
10. Aswani SM, Chandrashekar UK, Shivashankara KN, Pruthvi BC. Clinical profile of urinary tract infections in diabetics and non-diabetics. The Australasian Medical Journal. 2014;7(1):29-34.
11. Bissong MEA, Fon PN, Tabe-Besong FO, Akenji TN. Asymptomatic bacteriuria in diabetes mellitus patients in Southwest Cameroon. African Health Sciences. 2013;13(3):661-6.
12. Renko M, Tapanainen P, Tossavainen P, Pokka T, Uhari M. Meta-Analysis of the Significance of Asymptomatic Bacteriuria in Diabetes. Diabetes Care. 2011;34(1):230-5.
13. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Collet JT, Schneeberger PM, et al. Consequences of asymptomatic bacteriuria in women with diabetes mellitus. Arch Intern Med. 2001;161(11):1421-7.
14. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Hoekstra JB, Bouter KP, et al. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes Care. 2000;23(6):744-9.
15. Basu S, Ramchuran Panray T, Bali Singh T, Gulati AK, Shukla VK. A prospective, descriptive study to identify the microbiological profile of chronic wounds in outpatients. Ostomy Wound Manage. 2009;55(1):14-20.
16. Boyanova L, Mitov I. Antibiotic resistance rates in causative agents of infections in diabetic patients: rising concerns. Expert review of anti-infective therapy. 2013;11(4):411-20.
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IssueVol 7, No 3 (Summer2019) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jpc.v7i3.2354
Keywords
antibiotic resistance glycosylated hemoglobin uropathogen urinary tract infection diabetes mellitus

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How to Cite
1.
Haghighi M, Kariman H, Sistanizad M. Evaluating Association between Glycosylated Hemoglobin and the Spectrum and Antibiotic Resistance of Uropathogens: A Cross Sectional Study. J Pharm Care. 2019;7(3):67-71.