Epidemiology of Asymptomatic Bacteriuria among diabetic patients in Tikrit City, Iraq


  • Ahmed Juwameer Khairo Al-Khashmani Tikrit Health Directorate, Ministry of Health, Tikrit, Iraq.
  • Abid Ahmed Salman Department of Community and Family medicine, College of Medicine. University of Tikrit, Tikrit, Iraq.
  • Alaa Zanzal Raad Department of Community and Family medicine, College of Medicine. University of Tikrit, Tikrit, Iraq.




Asymptomatic bacteriuria, Diabetes Mellitus, risk factors, Urinary Tract Infections, Iraq


Objectives: This study aimed to show the Epidemiology of Asymptomatic Bacteriuria  among diabetic patients in Tikrit City, Iraq.

Methods: A cross sectional study was conducted in Tikrit city among diabetic and non-diabetic patients from General Salahalddin Hospital and from outpatient clinics. This study conduct 270 persons, including 155 diabetes sufferers and 115 non-diabetics. Consented subjects had their mid-stream urine collected, and each sample was examined using microscopy and culture techniques. Standard microbiological assays to determine the presence of pus cells and bacteria in urine were used to identify isolates.

Results: Asymptomatic Bacteriuria  (ASB) was found in 21.5 % of subjects, with diabetics having 26.4 % and non-diabetics having 14.8 %.  ASB is higher in the age group above 51 years 29 (50%),  Females 51 (88%) demonstrated a higher prevalence than males 7(12%) in both diabetic and non-diabetic groups. Staphylococcus epidermidis was the most common bacterium isolated from urine in both diabetics and non-diabetics (22.4 %). Other bacterium isolates included  E. coli (19%) , Enterococcus fecalis (13.7%), Klebsiella pneumonia (12%), and Enterobacter sp (12%), Staph aureus (10.3%), Staph saprophyticus (6.8%), Pseudomonas aerogenosa (3.4%). The most of isolated microorganisms were resistance to gentamycin, trimethoprim and cefotrixone.  Levofloxacin and ciprofloxacin were the most sensitive  to uropathogens caused by bacteria .

Conclusion: Diabetic sufferers had a higher prevalence of ASB (26.4%) than non-diabetics, according to the study (14.8 %). The majority of ASB was caused by Staphylococcus sp, indicating a shift in the aetiologic spectrum. The majority of isolates demonstrated multiple resistance in both diabetics and non-diabetics, indicating the necessity to increase antibiotic sensitization in Tikrit.


1- Shailesh P.S. I. R. Board, “Application Form of Research Proposal Gandaki medical college Institutional Review Board.2018.
2- Bissong M E A, Fon P N, Tabe Besong FO, Akenji TN. Asymptomatic bacteriuria in diabetes mellitus patients in Southwest Cameroon. African Health Sciences. 2013;13:661-666.
3- Odetoyin WB, Aboderin AO, Ikem RT, Kolawole BA, Oyelese AO. Asymptomatic bacteriuria in patients with Diabetes mellitus in Ile-Ife, South west Nigeria.East African Medical Journal. 2008;85:18-23.
4- Soo PB, Lee SJ, Wha KY, Sik HJ, Kim J, Chang SG, et al. Outcome of nephrectomy and kidney-preserving procedures for the treatment of emphysematous pyelonephritis. Scand J Urol Nephrol. 2006;40:332–338.
5- Bonadio M, Costarelli S, Morelli G, Tartaglia T. The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection. BMC Infectious Diseases 2006; 6 (54): 1-7.
6- Akoachere JFT, Suylika Y, Njom HA, Esemu NS. Etiologic profile and antimicrobial susceptibility of community-acquired urinary tract infection in two Cameroonian towns. BMC Research notes 2012;5: 219.
7- Yuyun MF, Angwafo III FF, Koulla-Shiro S, Zoung-Kanyi J. Urinary tract infections and genitourinary abnormalities in Cameroonian men. Trop Med Int Health 2004; 9 (4): 520-525.
8- Alebiosu CO, Osinupebi OA, Olajubu FA. Significant asymptomatic bacteriuria among Nigerian type 2 diabetics. J Natl Med Assoc 2003; 95: 344-351.
9- Lyamuya EF, Moyo SJ, Komba EV, Haule M. Prevalence, antimicrobial resistance and associated risk factors for bacteriuria in diabetic women in Dar es Salaam, Tanzania. Afr J Microbiol Res 2011; 5 (6): 683-689. 10- Hamdan HZ, Ziad AHM, Ali SK, and Adam I. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital. Annals Clin Microbiol Antimicrob 2011; 10(2).
11- Wogu MD, Ogbebor NE. Prevalence of asymptomatic bacteriuria in secondary school students in Benin City. Afr Res Rev 2011; 5 (4): 145-151.
12- Joshi N, Caputo GM, Weitekamp MR, Karchmer AW. Infections in patients with diabetes mellitus. New England Journal of Medicine. 1999;341:1906-1912.
13- Longdoh NA, Assob JCN, Nsagha SD, Nde PF et al. Uropathogens from diabetic patients with asymptomatic bacteriuria and urinary tract infections. The West London Medical Journal. 2013;5:7.14.
14- Sharma V, Gupta V, Mittal M. Prevalence of uropathogens in diabetic patients and their antimicrobial susceptibility pattern. National Journal of Laboratory Medicine. 2012;1:26-28.
15- Baqai R, Aziz M, Rasool G. Urinary tract infection in diabetics patients and biofilm formation of uropathogens. Infectious Disease Journal of Pakistan. 2008;17:21-24.
16- Assel MT, Al-Meer FM, Al-Kuwari MG, Ismail MF. Prevalence and predictor of asymptomatic bacteriuria among pregnant women attending 666 African Health Sciences Vol 13 Issue 3 September 2013 Primary health care in Qatar Middle East J Fam Med 2009; 4:14-17.
17- Zamanzad B, Moiezzi M. Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes type 2. J Res Health Sci 2006; 6 (1):14-20. 18- Omoregie R, Erebor JO, Ahonkhai I, Isibor JO, Ogofere H. Observed changes in the prevalence of uropathogens in Benin City, Nigeria. Nz J Med Lab Science 2008; 29-31.
19- Ishay A, Lavi I, Luboshitzky R. Prevalence and risk factors for asymptomatic bacteriuria in women with Type 2 diabetes mellitus. Diabet Med 2006; 23: 185-188.
20- Andriole V T. A symptomatic bacteriuria in patients with diabetes-enemy or innocent visitor? N England J Med 2002;347:1617-1618.
21- Patterson J E, Andriole V T. Bacterial urinary tracy infections ia diabetes. Infec dis clin North Am 1997;11:735-750.
22- Zaidi S.M.J, Kaneez M, Almas T., Laiba F., Abu Safian H., Jamal A.M., et al . Gauging the Risk Factors for Asymptomatic Bacteriuria in Type-2 Diabetic Women: A Case-Control Study. Published online 2020 Jul 8. doi: 10.7759/cureus.9069.page 8.
23- Kloos WE, Bannerman TL. Update on the clinical significance of coagulase-negative Staphylococci. Clin Microbiol Rev 1994;7 (1):117- 140. 24-Hansen D S. Gottschau.A. and Kolmos H.J. Epidemiology of Klebsiella bacteraemia: a case control study using E. coli bacteraemia as control J.Hosp. Infect,1998;38:119-132.
25- Stapleton A. Urinary tract infecyions in patients with diabetes. Am. J.Med.2002;113:80-84.
26- Ronald A. and Harding G. Complicated urinary tract infections. Infect.Dis.Cli.North Am,1997;11:583-592.
27- Gangoue PJ, Koulla SS, Ngassam P, Adiogo D, Ndumbe P. Antimicrobial activity against Gram negative bacilli from Yaounde Central Hospital, Cameroon. African Health Sciences 2006; 6 (4): 232-235.




How to Cite

Al-Khashmani, A. J. K., Salman, A. A., & Raad, A. Z. (2021). Epidemiology of Asymptomatic Bacteriuria among diabetic patients in Tikrit City, Iraq. Iraq Medical Journal, 5(3), 94–97. https://doi.org/10.22317/imj.v5i3.1041