Alexandre Malmartel1, Christian Ghasarossian2. 1. Université Paris Descartes, Faculté de Médecine, Department of family medicine, 24, rue du Faubourg Saint-Jacques, 75014 Paris, France. Electronic address: malmartel.alexandre@gmail.com. 2. Université Paris Descartes, Faculté de Médecine, Department of family medicine, 24, rue du Faubourg Saint-Jacques, 75014 Paris, France. Electronic address: docghasa@aol.com.
Abstract
BACKGROUND: With bacterial resistances having increased, patients with diabetes who are at higher risk of urinary tract infection (UTI) need to be studied. The study aim was to compare bacterial resistances to ofloxacin, cefixim, co-trimoxazole, nitrofurantoin and fosfomycin in UTI between patients with and without diabetes. METHODS: A cross-sectional study was conducted in ambulatory laboratories, including patients over 18 coming for urinalyses. Patients with diabetes were matched with two patients without diabetes based on risk factors for UTI using a propensity score. RESULTS: Among 1119 patients with UTI, 124 patients with diabetes were matched with 246 patients without diabetes. In patients with diabetes, the bacteria identified were: Escherichia coli (71%), Klebsiella (6%), Staphylococcus (5%), Enterococcus (4%), Proteus (2%) and Pseudomonas (1%); these findings were similar to those found in patients without diabetes. Resistances to ofloxacin and cefixim regardless of the bacteria were increased in patients with diabetes after matching on age, sex and history of UTI (respectively: OR=2.09; p=0.04 and OR=3.67; p=0.05). Regarding E. coli resistance, there was no difference whatever the antibiotic. CONCLUSION: The increased ofloxacin and cefixim resistance in patients with diabetes should be considered when prescribing probabilistic antibiotics, and could lead to changes in first-line treatments in UTI.
BACKGROUND: With bacterial resistances having increased, patients with diabetes who are at higher risk of urinary tract infection (UTI) need to be studied. The study aim was to compare bacterial resistances to ofloxacin, cefixim, co-trimoxazole, nitrofurantoin and fosfomycin in UTI between patients with and without diabetes. METHODS: A cross-sectional study was conducted in ambulatory laboratories, including patients over 18 coming for urinalyses. Patients with diabetes were matched with two patients without diabetes based on risk factors for UTI using a propensity score. RESULTS: Among 1119 patients with UTI, 124 patients with diabetes were matched with 246 patients without diabetes. In patients with diabetes, the bacteria identified were: Escherichia coli (71%), Klebsiella (6%), Staphylococcus (5%), Enterococcus (4%), Proteus (2%) and Pseudomonas (1%); these findings were similar to those found in patients without diabetes. Resistances to ofloxacin and cefixim regardless of the bacteria were increased in patients with diabetes after matching on age, sex and history of UTI (respectively: OR=2.09; p=0.04 and OR=3.67; p=0.05). Regarding E. coli resistance, there was no difference whatever the antibiotic. CONCLUSION: The increased ofloxacin and cefixim resistance in patients with diabetes should be considered when prescribing probabilistic antibiotics, and could lead to changes in first-line treatments in UTI.
Authors: Rodrigo M Carrillo-Larco; Cecilia Anza-Ramírez; Giancarlo Saal-Zapata; David Villarreal-Zegarra; Jessica Hanae Zafra-Tanaka; Cesar Ugarte-Gil; Antonio Bernabé-Ortiz Journal: J Epidemiol Community Health Date: 2021-07-29 Impact factor: 3.710