Study of Clinico-pathological and Bacteriological Profile of Urinary Tract Infections in Geriatric Patients with Type 2 Diabetes Mellitus

Introduction: The elderly with type2 Diabetes Mellitus(DM) have a greater frequency and severity of urinary tract infections(UTIs) due to long duration of DM, its neurovascular complications, long term insulin use, aging and suppression of immune system. The term UTI encompasses asymptomatic bacteriuria (ABU), urethritis, cystitis, prostatitis and pyelonephritis. Aims: To study the clinical and microbiological profileof UTI in patients more than 60 years of age having type2 DM. To examine whether the presence of diabetes alters the risks and complication profile for UTI’s in elderly. Materials and Methods: Cross-sectional, analytical study of elderly diabetic patients with UTI diagnosed on the basis of detailed clinical history and investigations. Results: Out of 60 study subjects, 24 were male and 36 were female with maximum incidence of UTI occurring in 65-69 years of age group. 66.67% of patients had diabetes for more than 10 years and more than 70% were on insulin therapy. HbA1c value was greater than 8 in 66.67% subjects. Foul smelling urine, dysuria and urgency were the commonest symptoms. Escherchiacoli (E coli) was the commonest pathogen isolated in 70% patients. 26.67% subjects had complicated UTI’s and acute kidney injury was the common complication Conclusion: E. Coli is the commonest organism causing UTI in elderly diabetics. There was no gender difference in the incidence of UTI. The possible risk factors for UTI in elderly diabetics are long duration of disease (more than 10 years), prolonged insulin therapy and high HbA1c values..