Evaluating the Risk Factors and Bidirectional Association of Urinary Tract Infections in Diabetes Mellitus
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Background. Urinary tract infections (UTIs) are the most predominant among people with diabetes mellitus (DM), with significant implications for morbidity and mortality. Various microbial agents, including bacteria, fungi, and viruses, contribute to UTIs in diabetic patients.
Objective. This review aims to examine the association between UTIs and DM, focusing on pathogenic mechanisms, risk factors, and clinical implications.
Methods. A comprehensive literature review was conducted to gather data on UTIs in diabetic patients. Relevant articles gathered from various databases, such as PubMed, Google Scholar, Semantic Scholar, and ScienceDirect were analyzed for insights into microbial colonization, pathogenic mechanisms, and epidemiological trends.
Results. Microorganisms commonly implicated in diabetic UTIs include Escherichia coli, Proteus mirabilis, Enterobacter spp., and Klebsiella spp. Elevated urinary glucose levels provide a conducive environment for microbial growth, contributing to increased infection rates. Risk factors such as female sex, obesity, glycosuria, immunosuppression, and diabetic complications (such as nephropathy and cystopathy) further exacerbate susceptibility.
Conclusion. The incidence of UTIs in diabetic populations is rising globally, provoked by antibiotic resistance among uropathogens such as Gram-negative bacteria including Escherichia coli (65-80%), trailed by Pseudomonas aeruginosa, Proteus mirabilis (2-6%), and Klebsiella spp. (3.5-13%). Whereas, Gram-positive bacteria include Staphylococcus spp. (4-6%), GBS (3%), Enterococcus faecalis (4-7%), and Candida (1%).
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