Analysis of drug resistance in patients with diabetes mellitus type 2 combined with urinary tract infection by Escherichia coli

Abstract

Background:
Urinary tract infections (UTIs) caused by Escherichia coli are common in patients with type 2 diabetes mellitus (T2DM), who are at higher risk of recurrent and complicated infections. Rising antimicrobial resistance poses a significant challenge in managing these infections effectively.
Objective:
To analyze the patterns of antimicrobial resistance in E. coli isolates from T2DM patients with UTIs, and to provide evidence for rational antibiotic use.
Methods:
A retrospective study was conducted on T2DM patients diagnosed with UTI caused by E. coli at [hospital/center] between [start date] and [end date]. Urine samples were collected for culture and antimicrobial susceptibility testing using the [Kirby–Bauer disk diffusion / automated system] method. The resistance rates of E. coli to commonly used antibiotics were analyzed, and associations with patient demographics, glycemic control, and infection severity were explored.
Results:
A total of [XXX] E. coli isolates were obtained from T2DM patients with UTIs. The highest resistance rates were observed against ampicillin ([X%]), trimethoprim-sulfamethoxazole ([X%]), and ciprofloxacin ([X%]). The lowest resistance rates were seen with carbapenems ([X%]) and nitrofurantoin ([X%]). Multidrug-resistant (MDR) E. coli strains accounted for [X%] of isolates. Poor glycemic control (HbA1c > [X]%) was significantly associated with higher rates of MDR infections (p < 0.05).
Conclusion:
E. coli isolates from T2DM patients with UTIs exhibit high levels of resistance to commonly used antibiotics, particularly β-lactams and fluoroquinolones. Carbapenems and nitrofurantoin remain effective options. Improved glycemic control and antimicrobial stewardship are critical to managing these infections and limiting the spread of resistance.
Keywords:
type 2 diabetes mellitus, urinary tract infection, Escherichia coli, antimicrobial resistance, multidrug resistance