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Diversity and complexity of urinary tract infection in diabetes mellitus

Department of Infectious Diseases, Victoria Hospital, Kirkcaldy, Fife, UK, lukman.hakeem{at}faht.scot.nhs.uk

Diptendu N Bhattacharyya

Department of Infectious Diseases, Victoria Hospital, Kirkcaldy, Fife, UK

Cyril Lafong

Department of Microbiology, Victoria Hospital, Kirkcaldy, Fife, UK

Khalid S Janjua

Department of Urology, Victoria Hospital, Kirkcaldy, Fife, UK

Jonathan T Serhan

Department of Radiology, Victoria Hospital, Kirkcaldy, Fife, UK

Ian W Campbell

Diabetes Centre, Victoria Hospital, Kirkcaldy, Fife, UK

Urinary tract infections (UTIs) are a common burden in patients with diabetes mellitus. Cystitis, ascending infections leading to pyelonephritis, emphysematous complications and renal and perinephric abscesses are well recognised in this group of patients especially if glycaemic control is poor. Despite the clinical significance of UTI in diabetes, it is inadequately understood and management regimens are mostly not evidence based. Anticipation of potential complications and earlier interventions are vital to reduce serious adverse outcomes. Herein we discuss the aetiology, pathogenesis and management of UTI and its local and more remote complications.

Key Words: aetiology • complications • diabetes • investigations • management • pathogenesis • UTI

References

• Wheat LJ Infection and diabetes mellitus. Diabetes Care 1980; 3:187-97.[Abstract]
• Thornton GF Infections and diabetes. Med Clin North Am 1971; 55:931-8.[Web of Science][Medline] [Order article via Infotrieve]
• Joshi N., Caputo GM, Weitekamp MR, Karchmer AW Infections in patients with diabetes mellitus. N Engl J Med 1999;341:1906-12.[Free Full Text]
• Ronald A., Ludwig E. Urinary tract infections in adults with diabetes. Int J Antimicrob Agents 2001;17:287-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Zhanel GG, Harding GKM, Nicolle LE Asymptomatic bacteriuria in patients with diabetes mellitus. Rev Infect Dis 1991;3:150-4.
• Zhanel GG, Nicolle LE, Harding GK Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group. Clin Infect Dis 1995;21:316-22.[Web of Science][Medline] [Order article via Infotrieve]
• Forland M., Thormas W., Shelokov A. Urinary tract infections in patients with diabetes mellitus: Studies on antibody coating of bacteria. J Am Med Ass 1977;238:1924-6.[Abstract/Free Full Text]
• Semethkowska-Jurkiewicz E., Horoszek-Mariarz S., Galinski J. et al. The clinical course of untreated asymptomatic bacteriuria in diabetic patients: 14 year follow-up. Mater Med Pol 1995;27:91-5.[Medline] [Order article via Infotrieve]
• Bonadio M., Meini M., Gigli C. et al. Urinary tract infectins in diabetic patients. Urol Int 1999;63:215-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Geerings SE Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment. Int J Antimicrob Agents 2008;31:54-7.[CrossRef]
• Nicolle LE, Friesen D., Harding GKM, Roos LL Hospitalisation for acute pyelonephritis in Manitoba, Canada during the period from1989-1992: impact of diabetes, pregnancy, and aboriginal origin. Clin Infect Dis 1995;22:1051-6.[Web of Science]
• Carton JA, Maradona JA, Nuno FJ et al. Diabetes mellitus and bacteraemia: a comparative study between diabetic and non diabetic patients. Eur J Med 1992;1:281-7.[Medline] [Order article via Infotrieve]
• Krogsgaard MR, Wagn P., Bengtsson J. Epidemiology of acute vertibral osteomyelitis in Denmark: 137 cases in Denmark 1978-1982, compared to cases reported to the National Patient Register 1991-1993. Acta Orthop Scand 1998;69:513-7.[Web of Science][Medline] [Order article via Infotrieve]
• Yin KS, Wang C., Lucero Y. Myelopathy secondary to spinal epidural abscess: case reports and review. J Spinal Cord Med 1998; 21:348-54.[Medline] [Order article via Infotrieve]
• Margo CE, Mames RN, Guy JR Endogenous Klebsiella endopthalmitis. Report of two cases and review of literature. Opthalmalogy 1994;101:1298-301.
• Huang JJ, Tseng CC Emphesematous pyelonephritis: clinico-radiological classification, management, prognosis, and pathogenesis. Arch Intem Med 2000;160;797-805.[CrossRef]
• Griffin MD, Bergstalhn EJ, Larson TS Renal papillary necrosis: a sixteen year clinical experience. J Am Soc Nephrol 1995;6:248-56.[Abstract]
• Smitherman KO, Peacock JE Jr. Infectious emergencies in patients with diabetes mellitus. Med Clin North Am 1995;79:53-77.[Web of Science][Medline] [Order article via Infotrieve]
• Michaeli J., Mogle P., Perlberg S. et al. Emphysematous pyelonephritis. J Urol 1984;131:203-8.[Web of Science][Medline] [Order article via Infotrieve]
• Edelstein H., McCabe RE Perinephric abscess: modern diagnosis andtreatment in 47 cases. Medicine (Baltimore ) 1988;67:118-31.[Medline] [Order article via Infotrieve]
• Valerius NH, Eff C., Hansen NE et al. Neutrophil and lymphocyte function in patients with diabetes mellitus. Acta Med Scand 1982;211:463-7.[Web of Science][Medline] [Order article via Infotrieve]
• Dalamaire M., Maugendre D., Moreno M. et al. Impaired leucocyte functions in diabetic patients. Diabet Med 1997;14:29-34.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Gallacher SJ, Thomson G., Fraser WD et al. Neutrophil bactericidal function in diabetes mellitus: evidence for association with blood glucose control. Diabet Med 1995;12:916-20.[Web of Science][Medline] [Order article via Infotrieve]
• Muchova J., Liptocova A., Orszaghova Z. et al. Antioxident systems in polymorphonuclear leucocytes of type 2 diabetes mellitus. Diabet Med 1999;16:74-8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Hoepelman AIM, Meiland R., Geerlings SE Pathogenesis and management of bacterial urinary tract infctions in adult patients with diabetes mellitus. Int J Antimicrob Agents 2003;22:35-43.[Web of Science][Medline] [Order article via Infotrieve]
• Geerlings SE, Brouwer EC, Van Kessel Kcpm et al. Cytokine secretion is impaired in women with diabetes mellitus. Eur J Clin Invest 2000;30:995-1001.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Geerlings SE, Brouwer EC, Gaastra W. et al. Effect of glucose and pH on uropathogenic and non-uropathogenic Escherichia coli: studies with urine from diabetic and non-diabetic individuals. J Med Microbiol 1999;48:535-9.[Abstract/Free Full Text]
• Delamaire M., Maugendre D., Moreno M. et al. Impaired leucocyte function in diabetic patients. Diabet Med 1997;14:29-34.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Balasoiu D., van Kessel KC, van Kats-Renaud HJ et al. Granulocyte function in women with diabetes and asymptomatic bacteriuria. Diabetes Care 1997;20:392-5.[Abstract]
• Geerlings SE, Meiland R., Van Lith EC et al. Adherence of type 1-fimbriated Escherichia coli to uroepithelial cells: more in diabetic women than in controls. Diabetes Care 2002;25:1405-9.[Abstract/Free Full Text]
• Leeker A., Kreft B., Sandman J. et al. Tamm-Horsfall protein inhibits binding of S-and P-fimbricated Escherichia coli to human renal tubular epithelial cells. Exp Nephrol 1997;5:38-46.[Web of Science][Medline] [Order article via Infotrieve]
• Torffvit O., Agardh CD Tubular secretion of Tamm-Horsfall protein is decreased in type 1 ( insulin dependant) diabetic patients with diabetic nephropathy. Nephron 1993;65:227-31.[Web of Science][Medline] [Order article via Infotrieve]
• Sawers JS, Todd WA, Kellett HA et al. Bacteriuria and autonomic nerve function in diabetic women. Diabetes Care 1986;9:460-4.[Abstract]
• Yang WH, Shen NC Gas forming infection of the urinary tract: an investigation of fermentation as a mechanism. J Urol 1990;143:960-4.[Web of Science][Medline] [Order article via Infotrieve]
• Hansen DS, Gottschau A., Kolmos HJ Epidemiology of Klebsiella bacteraemia: a case control study using Escherichia coli bacteraemia as control. J Hosp Infect 1998;38:119-32.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Munoz P., Llancaqueo A., Rodriguez-Creixems M. et al. Group B streptococcus bacteramia in nonpregnant adults. Arch Intern Med 1997; 157:213-6.[Abstract/Free Full Text]
• Shainuck LI, Fouty R., Cutler RE Emphysematous pyelonephritis: a new case and review of previous observations. Am J Med 1968;44:134-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Singh CR, Lytle WF Jr. Cystitis emphysematosa caused by Candida albicans. J Urol 1983;130:1171-3.[Web of Science][Medline] [Order article via Infotrieve]
• High KP, Quagliarello VJ Yeast perinephric abscess: report of a case and review. Clin Infect Dis 1992;15:128-33.[Web of Science][Medline] [Order article via Infotrieve]
• Fisher JF, Newman CF, Sobel JD Yeast in the urine: solutions for a budding problem. Clin Infect Dis 1995;20:183-9.[Web of Science][Medline] [Order article via Infotrieve]
• Solomon R., Werner C., Mann D. et al. Effects of saline, mannitol and furosemide to prevent acute decreases in renal function induced by radiocontrast agents. N Engl J Med 1994;331:1416-20.[Abstract/Free Full Text]
• Rodriguez-de-Valasquez A., Yoder IC, Valasquez PA, Papanicolaou N. Imaging the effects of diabetes in the genitourinary system. Radiographics 1995;15:1051-68.[Abstract]
• Kaplan DM, Rosenfield AT, Smith RC Advances in the imaging of renal function. Helical CT and modern coordinated imaging. Infect Dis Clin N Am 1997;11:681-706.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Ronald AR, Harding GKM. Complicated urinary tract infections. Infect Dis Clin N Am 1997;11:583-97.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Stamm WE, Hooton TM Management of urinary tract infections in adults. N Engl J Med 1993;329:1328-34.[Free Full Text]
• Mulvey MA, Schilling JD, Hultgren SJ Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection. Infect Immun 2001;69:4572-9.[Abstract/Free Full Text]
• Forland M., Thomas V., Shelokov A. Urinary tract infections in patients with diabetes mellitus. Studies on antibody coating of bacteria. JAMA 1997;38:1924-6.
• Warren JW, Abrutyn E., Hebel JR et al. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Clin Infect Dis 1999;29:745-58.[Web of Science][Medline] [Order article via Infotrieve]
• Talan DA, Stamm WE, Hooton TM et al. Comparison of ciprofloxacin (7 days) and trimethoprim-sulfamethoxazole (14 days) for acute uncomplicated pyelonephritis in women: a randomized trial. JAMA 2000;283:1583-90.[Abstract/Free Full Text]
• Moor CT, Roberts SA, Simmons G. et al. Extended-spectrum B-lactamase (ESBL)- producing enterobacteria: factors associated with infection in he community setting, Auckland, New Zealand. J Hosp Infect 2008;68:335-62.
• Wong-Beringer A. Theraputic challenges associated with extended spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Pharmacotherapy 2001;21:583-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Wong-Beringer A., Jacobs RA, Guglielmo J. Treatment of funguria. JAMA 1992;15:128-33.
• Frye KR,Donovan JM, Drach GW Torulopsis glabrata urinary infections: a review. J Urol 1988;139:1245-9.[Web of Science][Medline] [Order article via Infotrieve]
• Wise JG, Kozinn PJ, Goldberg P. Amphotericin B as a urologic irrigant in the management of noninvasive candiduria. J Urol 1982;128:82-4.[Web of Science][Medline] [Order article via Infotrieve]
• Fisher JF, Hicks BC, Dipiro JT et al. Efficacy of a single intravenous dose of amphotericin B in urinary tract infections caused by Candida. J Infect Dis 1987;156:685-7.[Web of Science][Medline] [Order article via Infotrieve]
• Leu HS, Huang CT Clearence of funguria with short course antifungal regimens: a prospective, randomised, controlled study. Clin Infect Dis 1995;20:1152-7.[Web of Science][Medline] [Order article via Infotrieve]
• Zagoria RJ, Dyer RB, Harrison LN, Adams PL Percutaneous managementmof localised emphesematous pyelonephritis. J Vasc Interv Radiol 1991;2:156-8.[Medline] [Order article via Infotrieve]
• Chen MT, Huang CN, Chou YH et al. Percutaneous drainage in the treatment of emphysematous pyelonephritis: 10-year experience. J Urol 1997;157:1569-73.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Stapleton A., Stamm WE Prevention of urinary tract infection. Infect Dis Clin N Am 1997;11:719-34.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]

The British Journal of Diabetes & Vascular Disease, Vol. 9, No. 3, 119-125 (2009)
DOI: 10.1177/1474651409105654


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hakeem, L. M Articles by Campbell, I. W Search for Related Content Social Bookmarking                         What's this?