ABSTRACT

Diabetes is a polygenic disease characterized by abnormally high glucose levels in the blood. There is evidence that patients with diabetes have an increased risk of Urinary Tract Infections (UTIs). UTI is the most common bacterial infection in diabetic patients. The study population included diabetic patients and non diabetic patients (attending five different Umuahia Health Care Facilities). Urine culture was carried out on the urine samples collected using MacConkey media. A total of four genera of bacteria were isolated namely; Escherichia coli, Staphylococcus aureus, Klebsiella spp and Pseudomonas spp. 70% of diabetics had positive urine cultures while 56% of non-diabetics had positive urine cultures. The most frequent bacteria isolated was Escherichia coli with a percentage value of 34.28%. The isolated micro-organisms were more sensitive to Gentamycin, Streptomycin and Ciproflox and more resistant to augmentin, ampicillin and ceporex. UTIs are frequent in diabetics, a great proportion of asymptomatic forms exist among diabetic patients therefore urine culture should be performed in all patients with diabetes.

TABLE OF CONTENTS

Certification i

Dedication ii

Acknowledgement iii

Table of Content iv

List of Tables vi

List of Figures                                                                                                                  vii

Abstract viii

CHAPTER ONE

1.0 INTRODUCTION 1

1.1 Objective of the study 3

1.3 Scope of study 4

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 Definition of urinary tract infection 5

2.2 Urinary tract infection in diabetic patients 5

2.2 Route of infection 6

2.3 Definitions 7

2.4 Factors contributing to urinary tract infection 9

2.4.1 Infections beginning in the urinary tract 10

2.5 Clinical features of urinary tract infection in diabetic patients 10

2.5.1 General features of UTI 11

2.5.2 Symptoms and signs of lower UTI 11

2.5.3 Symptoms of upper UTI 12

CHAPTER THREE

3.0 MATERIALS AND METHODS

3.1 Study area 13

3.2 Study population 13

3.3 Specimen collection 13

3.4 Isolation of micro-organisms 13

3.5 Characterization and identification of isolated micro-organisms 13

3.6 Gram stain 14

3.7 Biochemical tests 14

3.8 Antibiotic sensitivity test 17

3.9 Statistical analysis 18

CHAPTER FOUR

4.0 RESULTS 19

CHAPTER FIVE

5.0 DISCUSSION, CONCLUSION AND RECOMMENDATION

5.1 Discussion 29

5.2 Conclusion 30

5.3 Recommendation 30

REFERENCES

LIST OF TABLES

TABLE                   TITLE                                                                                          PAGE

1  Antibiotics for sensitivity test 17

2 Identification of isolates 21

3    Frequency of isolated organisms in diabetics compared to non-diabetics 22

4    Prevalence of organisms isolated from diabetics and non-diabetics 23

5    Antibiotic Sensitivity/Resistance Profile 26

7  Antibiotic Sensitivity/Resistance Profile 27

Table 8:    Antibiotic Sensitivity/Resistance Profile 28

LIST OF FIGURES

Fig. 1:    Bacteria Isolates Distribution of Diabetic and Non-Diabetic Subject 24