Prevalence, antimicrobial resistance, and risk factors of bacterial urinary tract infections among asymptomatic diabetes mellitus patients in Bahir Dar, Ethiopia.

INTRODUCTION

Diabetes mellitus associated with urinary tract infections. This study aimed to determine the prevalence of bacterial infection of urinary tract, assess antimicrobial resistance, and associated factors among asymptomatic diabetic patients attending Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, northwestern Ethiopia.

METHODS

An institution-based cross-sectional study was conducted from January to March 2025 among 248 diabetic patients. Sociodemographic and clinical data were collected using a structured questionnaire. Data were entered into EPI data 3.1 and exported to SPSS v.26. Bivariate and multivariable logistic regression analyses were used to identify factors associated with bacterial infection of urinary tract, with p < 0.05 considered statistically significant.

RESULTS

Of the 248 study participants, 63 (25.4%) had bacterial infection of urinary tract. Gram-negative bacteria predominated, with Escherichia coli (38.1%), Klebsiella pneumoniae (20.6%), and Acinetobacter baumannii (11.1%) being the most common isolates. High resistance was observed to commonly used antibiotics, including ampicillin, amoxicillin-clavulanate, chloramphenicol, and co-trimoxazole. In multivariable analysis, age 19-60 years (AOR = 3.95; 95% CI: 1.55-10.08), divorced marital status (AOR = 3.05; 95% CI: 1.02-9.09), prior history of UTI (AOR = 2.20; 95% CI: 1.12-4.33), and longer duration of diabetes (6-10 years: AOR = 3.85; >10 years: AOR = 5.50) were significantly associated with bacterial infection of urinary tract.

CONCLUSION

The findings of this study showed bacterial infection of urinary tract is common among asymptomatic diabetic patients, with a high burden of antimicrobial resistance. Antimicrobial stewardship programs, rational antibiotic use guided by culture and sensitivity testing are essential to reduce infection-related morbidity.