Bermejo HYE, Pimentel CA

Language: Spanish
References: 12
Page: 160-164
PDF size: 46.07 Kb.

ABSTRACT

Introduction: Urinary tract Infection (UTI) is defined as the presence and multiplication of microorganisms in the genitourinary system and may or may not exist symptoms. Every year there are approximately 150 million visits associated to urinary symptoms. The risk of acquiring a complicated UTI in patients with diabetes mellitus (DM) is twice as high in relation to general population. Urinalysis provides information for the detection of urinary infection by chemical and microscopic analysis of urine. Objective: To determine the usefulness of urinalysis as screening test for UTI in diabetic patients without urinary symptoms. Material and methods: Observational, prospective, transversal and analytical study. 114 diabetic patients without clinical evidence of urinary infection were included. A midstream urine sample was requested and UGA as well as urine culture were developed. Data were analyzed by descriptive and inferential statistics in contingency 2 x 2 arrays. Results: UTI was confirmed in 41 cases (35.9%) with a sensitivity-specificity to leukocyte esterase (LE), nitrites, leucocytes and bacteria analysis of 84.6%-93.3%, 43.46%-97.2%, 37.2%-83.3% and 93.6%-91% respectively. Conclusion: The bacteriuria analysis showed the best sensitivity and specificity to early diagnosis of IVU in diabetic patients without symptoms, and a routinely urinalysis in this patients population is recommended.

REFERENCES

1. Echevarría JZ, Sarmiento EA, Osores FP. Infección del tracto urinario y manejo antibiótico. Acta Med Ped 2006; 23(1): 26-31.

2. Hoepelman AI, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. International Journal of Antimicrobial Agents 2003; 22: S35-S43.

3. Gupta S, Koirala J, Khardori R, Khardori N. Infections in diabetes mellitus and hyperglycemia. Infect Dis Clin N Am 2007; 20: 617-638.

4. Neal DE. Complicated urinary tract infections. Urol Clin N Am 2008; 35: 13-22.

5. Barragán IA, Barriga GA, Calderón FF, Casasola JG et al. 1er Consenso Nacional sobre manejo antimicrobiano de infecciones de vías urinarias (IVUs) en el adulto. Boletín del Colegio Mexicano de Urología 2005; XX(2): 46-57.

6. Drekonja DM, Johnson JR. Urinary tract infections. Prim Care Clin Office Pract 2008; 35: 345-367.

7. Anuarios de morbilidad 2003-2008. Secretaría de Salud. Dirección General Adjunta de Epidemiología.

8. Flores EA, Parra IR, Jiménez AA, Fernández GT. Pruebas presuntivas del análisis de orina en el diagnóstico de infección en vías urinarias entre diabéticos tipo 2. Salud Pública Mex 2005; 47(5): 376-380.

9. Stapleton A. Urinary tract infections in patients with diabetes. Am J Med 2002;113 Suppl 1A: 80S-84S.

10. Litza JA, Brill JR. Urinary tract infections. Prim Care Clin Office Pract 2010; 37: 491-507.

11. Norris II DL, Young, JD. Urinary tract infections: Diagnosis and management in the emergency department. Emerg Med Clin N Am 2008; 26: 413-430.

12. American Academy of Pediatrics. Committee on Quality Improvement. Practice Parameter: The diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 1999; 103: 843-852.