Abstract:
Introduction: Silent bacteriuria or asymptomatic bacteriuria (ASB) means the existence of
bacteria in urine without clinical signs or symptoms of the host. Asymptomatic bacteriuria is
considered clinically significant and worth treating primarily in pregnant women.
Objectives: In this study, we examined the silent bacteriuria among diabetics and healthy
persons, type of strains, and their corresponding resistance pattern.
Materials and Methods: A total of 220 diabetic patients and 70 healthy persons were subjected
to study. Diabetic patients without malignancies, asthma or heart diseases, symptoms free
regarding urinary tract infection and without prior antibiotic administration were included.
Blood samples were obtained from all subjects under aseptic technique for fasting blood sugar
and HbA1c. Urine samples were collected. All urine samples were passed to cultivation on suitable
culture media. Plates of more than two clinical isolates from the same patient were considered to
be contaminated. Plates showing more than 104
CFU/mL were considered significant ASB and
subjected for confirmation of bacterial type and antibiotic susceptibility test.
Results: From diabetics urine samples, 21 (9.55%) and from healthy persons 3 (4.3%) showed
significant bacterial growth. In both diabetics and non-diabetics, women demonstrated a far
higher prevalence of ASB than men. The high the HbA1c, the more possibility of positive ASB.
In 66.7% of ASB, E. coli was the main uropathogens, followed by K. pneumoniae. These species
showed identical antibiotic resistance patterns.
Conclusion: These findings emphasize the importance of routine urine culture and antibiotic
sensitivity testing for diabetic patients who have identified risk factors. ASB should be treated
to avoid potential serious renal complications. Amikacin, gentamicin, piperacillin/tazobactam,
fosfomycin, and ciprofloxacin are recommended for treatment of ASB while ampicillin is not.
