URINARY TRACT INFECTIONS IN
DIABETIC PATIENTS IN LIBYA

Prof. Khalifa Sifaw Ghenghesh
Introduction
• Common and rare infections are reported more
frequently among patients with diabetes mellitus (DM)
than in ...
Introduction
• Escherichia coli is the major cause of UTIs.
• Other bacteria.

• Colonization of UT by uropathogenic E. co...
Introduction
• Treatment of UTIs
– Resistance rates to trimethoprim-sulphamethoxa-zole
exceeding 10% >> Ciprofloxacin and ...
Uropathogens isolated from DM and non-DM patients with UTIs
Organism
DM patients
(n=135)
E. coli
Klebsiella sp
Proteus sp
...
• Age, gender, education level and marital status had
no statistically significant influence (P > 0.05) on the
isolation o...
Antimicrobial sensitivity patterns of E. coli, Klebsiella sp. and
S. aureus isolated from DM and non-DM patients with UTIs
Ghenghesh KS., Elkateb E., Berbash N., Abdel
Nada R, Ahmed SF., Rahouma A, Seif-Enasser
N., Elkhabroun M-A., Belresh T., a...
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Urinary Tract Infection in Diabetic Patients-Libya

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Urinary Tract Infection in Diabetic Patients-Libya

  1. 1. URINARY TRACT INFECTIONS IN DIABETIC PATIENTS IN LIBYA Prof. Khalifa Sifaw Ghenghesh
  2. 2. Introduction • Common and rare infections are reported more frequently among patients with diabetes mellitus (DM) than in the general population – not universally accepted • Bacteriuria and urinary tract infections (UTIs) are more common in women with DM than in non-DM women. • Implicated factors: – Differences in host responses between DM and non-DM patients, – A difference in the infecting bacterium itself, – The presence of glucosuria and – Impairment of granulocyte function. • Others found no differences in such factors between the two groups.
  3. 3. Introduction • Escherichia coli is the major cause of UTIs. • Other bacteria. • Colonization of UT by uropathogenic E. coli (UPEC) is medicated by a variety of virulence factor (VF) that include: – Fimbrial (P, S/F1C and type 1 fimbriae) and non-fimbrial adhesins >> adherence to epithelia cells, – Siderophores >> iron-acquisition systems, – Toxins (haemolysin and cytotoxic necrotizing factor 1) and – Capsule forming polysaccharides >> immune evasion
  4. 4. Introduction • Treatment of UTIs – Resistance rates to trimethoprim-sulphamethoxa-zole exceeding 10% >> Ciprofloxacin and other fluoroquinolones. – Recently, high rates of antibiotic resistance among E. coli from UTIs including new drugs (i.e. ciprofloxacin) have been reported.
  5. 5. Uropathogens isolated from DM and non-DM patients with UTIs Organism DM patients (n=135) E. coli Klebsiella sp Proteus sp Enterobacter sp Citrobacter sp Serratia sp Pseudomonas sp Streptococcus sp S. aureus S. saprophyticus Candida albicans Total No organism 18 (13) 18 (13) 2 (1.5) 7 (5) 2 (1.5) 0 (0.0) 6 (4) 1 (1) 12 (9) 1 (1) 10 (7) 77 (57) 58 (43) No. (%) positive in: Non-DM patients (n=164) 29 (18) 23 (14) 9 (5.5) 7 (4) 4 (2) 3 (2) 7 (4) 5 (3) 12 (7) 2 (1) 9 (5.5) 110 (67) 54 (33) Total (n=299) 47 (16) 41 (14) 11 (4) 14 (5) 6 (2) 3 (1) 13 (4) 6 (2) 24 (8) 3 (1) 19 (6) 187 (62.5) 112 (37.5)
  6. 6. • Age, gender, education level and marital status had no statistically significant influence (P > 0.05) on the isolation of E. coli, Klebsiella sp. or S. aureus from DM and non-DM patients with UTIs. • No significant differences were found in the isolation rates of uropathogens from DM patients using oral medications when compared with those taking insulin (P > 0.05).
  7. 7. Antimicrobial sensitivity patterns of E. coli, Klebsiella sp. and S. aureus isolated from DM and non-DM patients with UTIs
  8. 8. Ghenghesh KS., Elkateb E., Berbash N., Abdel Nada R, Ahmed SF., Rahouma A, Seif-Enasser N., Elkhabroun M-A., Belresh T., and Klena JD. 2009. Uropathogens from diabetic patients in Libya: virulence factors and phylogenetic groups of isolated Escherichia coli. Journal of Medical Microbiology; 58: 1006-1014. ghenghesh_micro@yahoo.com ghenghesh@yahoo.com

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