Research Article
Prevalence, Antimicrobial Susceptibility Pattern, and Associated
Factors of Urinary Tract Infections among Adult Diabetic
PatientsatMetuKarlHeinzReferralHospital,SouthwestEthiopia
Tesfaye Gutema ,
1
Fitsum Weldegebreal ,
2
Dadi Marami ,
2
and Zelalem Teklemariam
2
1
Medical Microbiology Unit, Metu Karl Heinz Referral Hospital, Metu, Ethiopia
2
Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
Correspondence should be addressed to Tesfaye Gutema; 0917717390t@gmail.com
Received 28 July 2018; Accepted 3 September 2018; Published 1 November 2018
Academic Editor: Giuseppe Comi
Copyright © 2018 Tesfaye Gutema et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Urinary tract infection causes considerable morbidity in diabetic patients and if complicated, can cause severe renal damage and life-
threatening infections. e escalating antimicrobial resistance rate among bacteria over the past years is another concern in the treatment
of urinary tract infections. is study investigated the prevalence, antimicrobial susceptibility pattern of the isolates and associated factors
of urinary tract infection among adult diabetic patients attending Metu Karl Heinz Referral Hospital, Southwest Ethiopia. An
institutional-based cross-sectional study was conducted among 233 adult diabetic patients selected using simple random sampling
technique. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence
of pathogenic bacteria and their antimicrobial susceptibility pattern using recommended culture methods. Data were entered, cleaned,
and analyzed using the Statistical Program for Social Sciences version 21.0. Statistical significance was set at a p-value < 0.05. e
prevalence of urinary tract infection was 16.7% (95%, CI:12.0, 21.5). e predominant isolates were Escherichia coli (25.6%) and Klebsiella
spp. (20.5%). E. coli isolates showed higher sensitivity to ceftriaxone (80%), ciprofloxacin (70%), and gentamycin (70%), but resistant to
tetracycline (60%). Staphylococcus aureus was sensitive to amoxicillin-clavulanic acid (85.7%), and gentamycin (57.1%), while resistant to
tetracycline (85.7%), nitrofurantoin (85.7%), and ampicillin (71.4%). e odds of developing urinary tract infections were significantly
higher in diabetic females (AOR: 3.56, 95% CI:1.44, 8.76), those who were not able to read and write (AOR: 2.55, 95% CI:1.19, 5.49) and
those with a history of urinary tract infection (AOR: 2.31, 95% CI: 1.09, 4.90) compared with their counterparts. In this study, the
prevalence of urinary tract infection among diabetic patients was relatively comparable with the previous studies conducted in Ethiopia.
Management of urinary tract infection in diabetic patients should be supported with culture and antimicrobial susceptibility testing.
1. Introduction
Diabetes mellitus (DM) is a group of metabolic disorder
characterized by hyperglycemia resulting from defects in
insulin secretion, insulin action, or both [1]. DM has
become a serious public health threat in both developed
and developing countries, affecting more than 366 mil-
lion people, and the number is expected to rise to 552
million by 2030 [2]. International Diabetes Federation
estimated that 10.8 million people have DM in sub-
Saharan Africa in 2006, and this would rise to 18.7
million by 2025 [3].
Diabetes mellitus has long been considered to be
a predisposing factor for urinary tract infection (UTI) be-
cause of sugar in urine, which serves as media for growth of
bacteria [4, 5]. e colonized urinary tract can also accelerate
the prolonged release of bacteria with an increased risk of
complications of the urinary system, ranging from dysuria
(pain or burning sensation during urination) to the organ
damage and sometimes even death [6, 7]. e most common
bacteria associated with UTI in diabetics are Escherichia coli,
Proteus spp., Klebsiella spp., Pseudomonas aeruginosa, En-
terococcus spp., Staphylococcus aureus, and coagulase-
negative staphylococci (CoNS) [7, 8].
Hindawi
International Journal of Microbiology
Volume 2018, Article ID 7591259, 7 pages
https://doi.org/10.1155/2018/7591259