Prevalence and Antibiogram Pattern of Uropathogens Among Diabetic and Non-Diabetic Patients in Erbil-Kurdistan region of Iraq

The increased rate of Urinary Tract Infections (UTIs) in immunocompromised patients such as those with diabetes mellitus has become a major international health issue in developing countries. Therefore, this study was conducted to determine the differences in the prevalence of etiological agents between diabetic and non-diabetic individuals, to study the influence of diabetes mellitus on the antibiogram patterns, and to demonstrate extended spectrum β-lactamases (ESBLs) producing bacteria. This prospective cross-sectional study was conducted among 60 non-duplicated diagnosed diabetic and 60 non-diabetic patients. Midstream urine sample were collected and cultured for the diagnosis of bacteriuria. All Gram-negative uropathogens were phenotypically studied for  β-lactamase production. Among all 120 patients, the incidence rate of bacteriuria in diabetic and non-diabetic female participants (76.7%, 80%) was significantly higher than in males (23.3%, 20%), respectively. The most frequent isolated uropathogens in patients with and without diabetes mellitus were Escherichia coli (53.3%, 46.7%) followed by Staphylococcus aureus (23.3%, 16.7%), respectively. Antibiogram patterns revealed that most bacterial isolates were highly susceptible to Imipenem, Meropenem, Ertapenem, Nitrofurantoin, and Vancomycin. Moreover, multi-drug resistance was observed among 70% of UTI patients. The overall prevalence of ESBL in the non-diabetic group was significantly higher than diabetic (68.8%,35.3%). E. coli was the predominant b-lactamase producer in diabetic (37.5%) and non-diabetic (64.3%) individuals. ESBL producers showed a higher resistance level against 20 used antibiotics than non-ESBL producers. This study has shown a significant relationship between the proportion of bacterial isolates and urinary tract infections in diabetic and non-diabetic patients.