JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v6i1.2515 jpsim.v6i1.2515 Original Research Frequency of Uropathogens in Patients Admitted with Urinary Tract Infection and Diabetes Mellitus Anwar Sidra sid_anwar786@hotmail.com * Benyamin Javeria Rauf Muhammad Kamran Fatima Memorial Hospital/Medical College Lahore Pakistan *Correspondence: Sidra Anwar (sid_anwar786@hotmail.com) 10 03 2025 2025 6 1 71 77 11 06 2024 18 02 2025 23 02 2025 Copyright © 2025 The Author(s) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

We aimed to identify and classify the specific uropathogens responsible for UTIs in patients with DM who require hospitalization and to determine the prevalence of urinary tract infections (UTIs) in patients admitted to healthcare facilities with coexisting Diabetes Mellitus (DM).

 Methodology

The prospective study conducted at Fatima Memorial Hospital in Lahore, Pakistan (November 2023 to January 2024) involved 116 participants recruited through Non-Probability Sampling. Data analysis utilized IBM SPSS version 26. Descriptive analysis covered variables (age, gender, UTI symptoms and urine culture reports). Categorical variables (e.g., gender, UTI symptoms and organisms in culture reports) were presented as frequencies and percentages using pie and bar charts. Quantitative variable age, was expressed as mean±SD.

 Results

Involving 116 participants (31% male, 69% female, average age 45.20, SD = 21.16), urine analysis revealed Escherichia coli (48.3%), Enterococcus Faecium (13.8%), Candida Tropicalis (5.2%), and 32.8% with no growth. Common symptoms include fever (49.1%), dysuria (63.8%), urgency (87.9%), and lower abdominal pain (66.4%).

 Conclusion

Urinary tract infections (UTIs) are highly prevalent in patients with type 1 and type 2 diabetes mellitus. These infections tend to be more severe and are caused by pathogens with higher resistance levels. Our study of 116 participants revealed a significant female predominance in UTI cases for both diabetes types. The most common uropathogen was Escherichia coli, followed by Enterococcus faecium and Candida tropicalis. These findings provide a comprehensive understanding of UTIs in diabetic patients and contribute to more effective clinical outcomes.

 Keywords Diabetes Mellitus Urinary tract infection Uropathogens frequency Escherichia Coli Enterococcus faecium Candida Tropicalis. Ethics Statement

Ethics committee: Institutional Review Board, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. Approval number: FMH-04/10/2023-IRB-1322, dated 16-11-2023.

 References Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269-84. Nitzan O, Elias M, Chazan B, Saliba W. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes Metab Syndr Obes. 2015; 10.2147/DMSO.S51792. Nath T, Das SK, Hazra S. Pattern of uropathogens and antibiotic sensitivity in diabetes patients attending to out - Patient department and diabetes clinic of a teaching hospital: A cross-sectional study. J Family Med Prim Care. 2021;10(10):3638-43. Czajkowski K, Broś-Konopielko M, Teliga-Czajkowska J. Urinary tract infection in women. Prz Menopauzalny. 2021 Apr;20(1):40-7. Kamei J, Yamamoto S. Complicated urinary tract infections with diabetes mellitus. J Infect Chemother. 2021;27(8):1131-6. Puckrin R, Saltiel MP, Reynier P, Azoulay L, Yu OHY, Filion KB. SGLT-2 inhibitors and the risk of infections: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol. 2018; 55(5):503-14. Silago V, Moremi N, Mtebe M, Komba E, Masoud S, Mgaya FX, et al. Multidrug-Resistant Uropathogens Causing Community Acquired Urinary Tract Infections among Patients Attending Health Facilities in Mwanza and Dar es Salaam, Tanzania. Antibiotics (Basel). 2022;11(12):1718. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Collet TJ, Hoepelman AI. Diabetes Women Asymptomatic Bacteriuria Utrecht Study Group. Risk factors for symptomatic urinary tract infection in women with diabetes. Diabetes Care. 2000;23(12):1737-41. Alhajouj MS, Alsharif GS, Mirza AA. Impact of Sequential Passaging on Protein Expression of E. coli Using Proteomics Analysis. Int J Microbiol. 2020;10.1155/2020/2716202. Seifu WD, Gebissa AD. Prevalence and antibiotic susceptibility of Uropathogens from cases of urinary tract infections (UTI) in Shashemene referral hospital, Ethiopia. BMC Infect Dis. 2018 Jan 10;18(1):30. 10.1186/s12879-017-2911-x. PMID: 29320984; PMCID: PMC5763535. Muhammad A, Khan SN, Ali N, Rehman MU, Ali I. Prevalence and antibiotic susceptibility pattern of uropathogens in outpatients at a tertiary care hospital. New Microbes New Infect. 2020; 10.1016/j.nmni.2020.100716. Kauffman CA, Vazquez JA, Sobel JD, Gallis HA, McKinsey DS, Karchmer AW, Sugar AM, et al. Prospective multicenter surveillance study of funguria in hospitalized patients. The National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group. Clin Infect Dis. 2000;30(1):14-8. Achkar JM, Fries BC. Candida infections of the genitourinary tract. Clin Microbiol Rev. 2010;23(2):253-73. Chai LY, Denning DW, Warn P. Candida tropicalis in human disease. Crit Rev Microbiol. 2010;36(4):282-98. Kafil HS, Asgharzadeh M. Vancomycin-resistant enteroccus faecium and enterococcus faecalis isolated from education hospital of iran. Maedica (Bucur). 2014;9(4):323-7. Gatt D, Lendner I, Ben-Shimol S. Catheter-obtained, Enterococcus and Proteus positive urine cultures may represent mostly contamination or asymptomatic bacteriuria in infants LaRocco MT, Franek J, Leibach EK, Weissfeld AS, Kraft CS, Sautter RL, et al. Effectiveness of Preanalytic Practices on Contamination and Diagnostic Accuracy of Urine Cultures: a Laboratory Medicine Best Practices Systematic Review and Meta-analysis. Clin Microbiol Rev. 2016;29(1):105-47. Bhugra A, Gachinmath S. Significant bacteriuria among requested repeat urine samples and its clinical correlation. Iran J Microbiol. 2021;13(5):592-601. Geerlings SE. Clinical Presentations and Epidemiology of Urinary Tract Infections. Microbiol Spectr. 2016;4(5):10-128. Bono MJ, Leslie SW, Reygaert WC. Uncomplicated urinary tract infections. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023 Nov 13.