Rakhshanda Baqai, Mubashir Aziz, Ghulam Rasool.
Urinary tract infection in diabetic patients and Biofilm formation of Uropathogens.
Infect Dis J Jan ;17(1):7-9.

Objective: To determine the etiological agents of urinary tract infection (UTI) and their antibiotic sensitivity pattern. Formation of biofilms among uropathogens was also analyzed. Material and Methods: One hundred urine samples were collected randomly from out patients attending the Diabetic Clinic at Jinnah Postgraduate Medical Centre, Karachi. Mid stream urine samples were collected in sterile containers Patients on antibiotic therapy were excluded from the study. Routine analysis of urine was done with URS strips, Techno Diagnostic USA. Urine samples were inoculated on MacConkey’s agar, Cystine lactose electrolyte deficient (CLED) medium with a calibrated loop to determine colony forming units (CFU). Identification of isolates was done by colony morphology, gram staining and standard biochemical tests and Quick Test Strip (QTS). Antibiotic susceptibility test was done by disc diffusion. Urine samples were also inoculated on Sabouraud’s agar for the detection of fungus, and identification was done by colony morphology and staining. Detection of biofilms was done by simple tube method and quantitative estimation by spectrophotometer assay. Results: There were 64 male patients; females were of age range 40-49 years and males 50-59 years. Urinanalysis showed nitrite was present in 95%, protein 94%, leucocytes 91%, glucose 64%, ketone bodies 8 % and red blood cells in 4% of cases. Among 100 urine samples, there was significant growth in 21%, not significant in 34% and no growth in 45%. Escherichia coli 50% was the predominant organism followed by Staphylococcus aureus 20%, Staphylococcus saprophyticus 20 %, Proteus spp 20% and Enterococcus faecalis 17%. Candida was isolated in 10.2 % of cases. E.coli indicated sensitivity to tetracycline 64%, ciprofloxacin 58%, amoxycillin clavulanic acid 57%, aztreonam 50%, chloramphenicol 50%, cefazolin 42%, trimethoprim 28% and cephalothin 21%. Biofilms production of uropathogens was detected in 75% of the isolates from UTI, mainly from S.aureus (75 %), E.faecalis (75%) and E.coli (40%). Conclusion: E.coli is the main uropathogen in UTI in patients with type 2 diabetes, and uropathogens forming biofilms indicate their role in persistence of infection and drug resistance.

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