A STUDY OF THE PREVALENCE OF BACTERIURIA IN FEMALE DIABETIC PATIENTS ATTENDING THE MULAGO HOSPITAL DIABETIC CLINIC (MHDC)

BETWEEN FEBRUARY AND MAY, 1991.

BY: NAKIBIRANGO JANE FRANCES M.B.Ch. B (MUK).

A DISSERTATION SUBMITTED AS PARTIAL FULFILMENT FOR THE DEGREE OF MASTER OF MEDICINE (INTERNAL MEDICINE) OF MAKERERE UNIVERSITY KAMPALA, 1991.

SUPERVISORS: PROF. M.A. OTIM M.R.C.P., M.D.

PROFESSOR OF MEDICINE

DEPT. OF MEDICINE, MAKERERE UNIVERSITY.

DR. EDWARD KIGONYA M.D.

SENIOR CONSULTANT PHYSICIAN

DEPT. OF MEDICINE, MULAGO HOSPITAL.

ABSTRACT

Background:
Bacteriuria is three to five fold more common in diabetic than in non-diabetic women. Most cases of bacteriuria are asymptomatic and may therefore remain undiagnosed unless actively screened for. Yet the occurrence of bacteriuria in female diabetics predisposes to severe urinary tract infections (UTI) and their complications. The prevalence of bacteriuria in Ugandan diabetics is not known but UTI is thought to be a frequent ailment in this population.

Methods:
From February 13th to May 29th, 1991, bladder aspirated urine specimens from 100 diabetic women attending the Mulago Hospital Diabetic clinic (MHDC) were studied. The prevalence of bacteriuria, the bacterial aetiologic agents and their antibiotic sensitivity profiles were evaluated.

Results:
Bacteriuria occurred in 12% of patients. Symptoms and signs of UTI, although fairly common (27%) were not correlated with presence of bacteriuria. The bacterial organisms isolated included E.Coli (58%), Klebsiella species (25%), Pseudomonas aeruginosa (8%) and Citrobacter freundii (8%). There was a high degree of resistance to antibiotics commonly prescribed

in Mulago Hospital including cotrimoxazole (75%), tetracycline (75%), ampicillin (75%), chloramphenicol (67%) and nitrofurantoin (50%). Candiduria was an incidental finding in 35% of cases.

Conclusion:
Bacteriuria is fairly common in diabetic women attending MHDC. The course and associated urinary tract morbidity however need further evaluation. Larger studies are needed to evaluate further, the bacterial causes and their antibiotic sensitivity profiles.

KEYWORDS[ diabetes, nutrition, parasites, hypertension ]