Asymptomatic Bacteriuria (ASB) in diabetic patients: Treat or not to treat: A prospective, observational study conducted at a tertiary care hospital

BACKGROUND: The term asymptomatic bacteriuria (ASB) refers to the isolation of bacteria in a urine specimen of individuals who denied symptoms of urinary tract infection. Diabetes mellitus (DM) is a disease involving multiple organ systems, hallmarked for its chronicity and thus-forth endless complications including asymptomatic bacteriuria. OBJECTIVES: This study aimed to determine the characteristics of asymptomatic bacteriuria and antibiotic susceptibility pattern amongst patients with diabetes. SETTINGS AND DESIGN: A prospective observational study was conducted at a tertiary care hospital in Karachi, Pakistan. METHODS AND MATERIAL: The study included all those patients with a diagnosis of diabetes with no signs and symptoms of urinary tract infection but showing the growth of an organism in urine culture. Pregnant females and subjects who used antibiotics in last two weeks were excluded. A total of 222 urine cultures were observed prospectively who met the inclusion criteria through non-probability consecutive sampling. RESULTS: Out of 222 urine cultures observed, mean age of subjects were 62.89 ± 13.77 out of which 76% were females, and 61% had a family history of diabetes. The most frequent organisms isolated were Escherichia. Coli (E. Coli), Enterococcus, Klebsiella, Pseudomonas, and Enterobacter species. A total of 20 subjects got dual bacterial growth in their cultures among which 17 subjects had a growth of Enterococcus with any other pathogen causing UTI. Gender, family history of diabetes, levels of HBA1c, and older age groups all were found significantly associated with ASB. CONCLUSIONS: Our study is the first to analyze and study the associated risk factors amongst ASB in DM patients, and to identify the pathogens involved along with assessing their antibiotic resistance profiles. Also, due to the increase resistance to antibiotics we would recommend to use antibiotics in ASB patients only if they have any two or more comorbidities.