Spectrum of uropathogens in diabetic patients at Nkhata-Bay District Hospital, Malawi: a hospital-based cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Urinary tract infections (UTIs) are more common in diabetic patients due to immune suppression associated with hyperglycemia, which promotes the growth and proliferation of uropathogens. The emergence of antibiotic resistance among these pathogens further complicates treatment and increases the risk of adverse clinical outcomes. This study was conducted to investigate the pattern of UTIs among diabetic patients at Nkhata-Bay District Hospital in Malawi, where such data remain scarce. A prospective cross-sectional study was conducted from 1st to 30th September 2024 among 64 symptomatic and asymptomatic diabetic patients selected through systematic sampling. Midstream urine samples were collected, and standard culture and biochemical tests were performed to identify bacterial uropathogens. Antibiotic susceptibility testing was carried out using the Kirby-Bauer disk diffusion method in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Data were analyzed using SPSS version 27, with logistic regression employed to identify risk factors. A p-value of less than 0.05 was considered statistically significant. A total of 64 urine samples were processed, with significant bacterial growth observed in 35 samples (55%). Frequent urination was the most commonly reported urinary symptom (47, 73%), while proteinuria, leukocyturia, and glucosuria were each detected in 53% (34) of participants. Escherichia coli (11, 31%) and coagulase-negative Staphylococci (7, 20%) were the predominant uropathogens. Bacteriuria was slightly more common in males (18, 56%) and also predominant in the age group of 19–39 years (11, 55%). Gram-negative bacteria were fully susceptible to amikacin and meropenem (100%) but completely resistant to ampicillin and nitrofurantoin (100%), particularly E. coli . Significant bacteriuria was highly prevalent among diabetic patients at Nkhata-Bay District Hospital, with E. coli and coagulase-negative Staphylococci as the most common pathogens. The high antibiotic resistance observed highlights the need for routine urine culture and susceptibility testing among diabetic patients to guide effective antibiotic therapy, improve patient outcomes, and support antimicrobial stewardship. Not applicable.
Source: BMC Infectious Diseases
Authors: Precious Chisale, Pizga Kumwenda
Institution: Mzuzu University
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7225330619