|
1
|
Sorescu T, Cosnita A, Braha A, Timar R, Timar B, Licker M, Lazar S, Gaita L, Albai O, Popescu S. Predictive Factors for Urinary Tract Infections in Patients with Type 2 Diabetes. J Clin Med 2024; 13:7628. [PMID: 39768552 PMCID: PMC11727733 DOI: 10.3390/jcm13247628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 12/08/2024] [Accepted: 12/12/2024] [Indexed: 01/03/2025] Open
Abstract
Background/Objectives: Patients with diabetes (DM) are at an increased risk of infection, with urinary tract infections (UTIs) being common among individuals with type 2 DM (T2D). The aim of this study was to determine the prevalence and risk factors for UTIs among hospitalized T2D patients from Timișoara, Romania. Methods: The hospital records of 1139 T2D adult inpatients who were ordered to provide urine cultures during hospitalization were reviewed. Results: The prevalence of UTIs among T2D patients was 19.7%, and was higher in women than in men (27.5% vs. 9.8%, p < 0.0001). Patients with UTIs presented a significantly older age, a longer duration of DM, a higher BMI, higher levels of HbA1c, higher renal function parameters, and more frequent DM-related complications and comorbidities than patients without UTIs. The following predictors were associated with increased UTI risk: age (OR = 1.05, p < 0.0001); duration of DM (OR = 1.04, p < 0.0001); BMI (OR = 1.05, p < 0.0002); HbA1c levels (OR = 1.58, p < 0.0001); female gender (OR = 3.47, p < 0.0001); and the presence of retinopathy (OR = 1.47, p = 0.0118), chronic kidney disease (OR = 3.98, p < 0.0001), distal symmetric polyneuropathy (OR = 7.65, p < 0.0001), and cerebrovascular disease (OR = 4.88, p < 0.0001). The use of sodium-glucose co-transporter 2 (SGLT2) inhibitors did not influence the risk of developing UTIs. Conclusions: T2D patients with prolonged disease duration, poor glycemic control, and DM-related complications are at an increased risk of developing UTIs. Therefore, a targeted therapeutic strategy addressing these risk factors is essential.
Collapse
Affiliation(s)
- Teodora Sorescu
- Second Department of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (T.S.); (A.B.); (R.T.); (B.T.); (L.G.); (O.A.); (S.P.)
- Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brînzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Andrei Cosnita
- Department IX, Surg & Ophthalmol, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adina Braha
- Second Department of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (T.S.); (A.B.); (R.T.); (B.T.); (L.G.); (O.A.); (S.P.)
- Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brînzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Romulus Timar
- Second Department of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (T.S.); (A.B.); (R.T.); (B.T.); (L.G.); (O.A.); (S.P.)
- Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brînzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Bogdan Timar
- Second Department of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (T.S.); (A.B.); (R.T.); (B.T.); (L.G.); (O.A.); (S.P.)
- Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brînzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Monica Licker
- Microbiology Department, Multidisciplinary Research Center of Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Microbiology Laboratory, “Pius Brinzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
| | - Sandra Lazar
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- First Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Doctoral School of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Hematology, Emergency Municipal Hospital, 300254 Timisoara, Romania
| | - Laura Gaita
- Second Department of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (T.S.); (A.B.); (R.T.); (B.T.); (L.G.); (O.A.); (S.P.)
- Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brînzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Oana Albai
- Second Department of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (T.S.); (A.B.); (R.T.); (B.T.); (L.G.); (O.A.); (S.P.)
- Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brînzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Simona Popescu
- Second Department of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (T.S.); (A.B.); (R.T.); (B.T.); (L.G.); (O.A.); (S.P.)
- Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brînzeu” Emergency Clinical County Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| |
Collapse
|
|
2
|
Sugai K, Sasaki J, Wada Y, Shimizu N, Ishikawa T, Yanagi K, Hashimoto T, Tanaka A, Suwanai H, Suzuki R, Odawara M. Predictive patterns of lower urinary tract symptoms and bacteriuria in adults with type 2 diabetes. Diabetol Int 2024; 15:253-261. [PMID: 38524941 PMCID: PMC10959893 DOI: 10.1007/s13340-023-00687-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/11/2023] [Indexed: 03/26/2024]
Abstract
Background Numerous studies demonstrated the risk factors for urological complications in patients with diabetes before sodium-glucose co-transporter 2 inhibitor (SGLT2i) became commercially available. This study aimed to comprehensively investigate urological characteristics in patients with type 2 diabetes (T2DM) after SGLT2i became commercially available. Methods We examined 63 outpatients with T2DM suspected of bacteriuria based on urinary sediment examinations. Urine cultures were performed, and lower urinary tract symptoms (LUTS) were assessed via questionnaires. Patients with bacteriuria were assessed using ultrasonography to measure post-void residual volume (PVR). Utilizing demographic and laboratory data, a random forest algorithm predicted LUTS, bacteriuria, and symptomatic bacteriuria (SB). Results Thirty-two patients had LUTS and 31 had bacteriuria. High-density lipoprotein cholesterol level was crucial in predicting LUTS, while age was crucial in predicting bacteriuria. In predicting SB among patients with bacteriuria, creatinine level and estimated glomerular filtration rate were crucial. Our models had high predictive accuracy for LUTS (area under the curve [AUC] = 0.846), followed by bacteriuria (AUC = 0.770) and SB (AUC = 0.938) in receiver operating characteristic curve analysis. These predictors were previously reported as risk factors for urological complications. Although SGLT2i use was not an important predictor in our study, all SGLT2i users with bacteriuria had SB and exhibited higher PVR compared to non-SGLT2i users with bacteriuria. Conclusion This study's random forest model highlighted distinct essential predictors for each urological condition. The predictors were consistent before and after SGLT2i became commercially available. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-023-00687-1.
Collapse
Affiliation(s)
- Keiji Sugai
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Junko Sasaki
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Yuki Wada
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Norihiro Shimizu
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Takuya Ishikawa
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Ketchu Yanagi
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Takeshi Hashimoto
- Department of Urology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Akihiko Tanaka
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
| | - Hirotsugu Suwanai
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Ryo Suzuki
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Masato Odawara
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| |
Collapse
|