Asymptomatic bacteriuria in patients with diabetes Mellitus in Ile-Ife, South-West, Nigeria

Objectives: To investigate the prevalence and associates of asymptomatic bacteriuria (ASB) in a sample of Nigerian diabetic patients. Design: Cross-sectional descriptive and analytic study. Setting: The Wesley Guild Hospital and Ife State Hospital, both units of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Subjects: One hundred and thirty five diabetic patients and 57 non-diabetic patients as controls. Main outcome measures: Demographic parameters of participants were recorded. Significant bacteriuria was determined for each of the mid-stream urine specimen obtained from all the subjects. Organisms isolated were identified and evaluated for antibiotic susceptibility patterns. Results: There was a significant difference in the prevalence of ASB in the two groups. Prevalence of ASB was 16% and 3.5% in the diabetic patients and control respectively (p=0.03). Demographic parameters except age were not related to the presence of ASB. ASB was found in 54.4% of diabetic patients with poor glycaemia control compared with 2.9% in diabetics with good glycaemia control (p = 0.006). Organisms associated with ASB were Staphylococcus aureus, Klebsiella sp, Escherichia coli and Enterococcus faecalis, however the most predominant was Staphylococcus aureus. These organisms were largely resistant to the common antibiotics tested such as cotrimoxazole and gentamicin but susceptible to nitrofurantoin. Conclusions: The prevalence of ASB is high in diabetic patients and poor glucose control can be considered a predisposing factor.