URINARY-TRACT INFECTIONS IN PATIENTS WITH DIABETES-MELLITUS

Urinary tract infections (UTI) are very often encountered in patients with diabetes mellitus. They may present themselves as asymptomatic ba cteriuria, but may also lead to more serious infections. In most cases the kidney is involved, although signs and symptoms of renal infectio n may not be present. Asymptomatic bacteriuria is more prevalent in wo men, but not men, with diabetes mellitus compared to controls. Studies yield conflicting results, probably due to selection bias, about asso ciated risk factors. The pathogens cultured are those seen in all comp licated urinary tract infections. The suggested mechanisms of an incre ased susceptibility to UTI are (a) decreased antibacterial activity du e to the 'sweet urine', (b) defects in neutrophil function, and (c) in creased adherence to uroepithelial cells. The latter is the most likel y. UTI in diabetics should be treated as complicated UTI with agents r eaching high tissue levels for 10-14 days.