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The clinical significance of urinary tract infection and Asymptomatic Bacteriuria in Type 2 Diabetes Mellitus patients in the general practices of Varna region - Bulgaria

Abstract

Background: The urinary system of diabetics is one of their most frequently affected body systems. Periodic urine analysis reveals that asymptomatic bacteriuria is very often detected in this population. Objectives: The aim of the study is to estimate the clinical significance of upper urinary tract infection (UUT/) and asymptomatic bacteriuria (ABU) in diabetics in a general practice setting, their clinical characteristics, incidence, course, evolution and complications. Methods: We tested 560 patients with type 2 diabetes mellitus (DM) from 12 general practices ofVarna region, Bulgaria in a prospective study. We traced ABU in the group for 2 years. There were 310 female patients (55.4%) mean age 52.5 ± 3.2 years and duration of DM was 8.5 ± 2.8 years. Results: The results showed that in 11.14% ABU was significant. Only 4.82% of diabetics developed upper urinary tract infection and the complications from it were very rare: 0.89% pyonephrosis and 0.89% sepsis. Conclusions: Our conclusion was that upper urinary tract infection in diabetics was not as severe as reported in the literature. Pyelonephritis had a benign course and only 16.6% of our patients developed chronic renal failure a few years later but the reason for its development was not diabetic nephropathy. All these facts show that ABU disappears spontaneously in most diabetics. Relevance to general practice: We discuss the question: is it necessary for every case of ABU in diabetics in general practice to be treated and isn't it time to revaluate the postulated antibiotic treatment for diabetics with ABU?peer-reviewe

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