Introduction: Diabetic neurogenic bladder is one of the common complications in patients with diabetic neuropathy. However, studies reporting the prevalence and associated factors of urinary tract infections (UTIs) in patients with diabetic neuropathy are rare. Therefore, the present study aimed to explore the prevalence and influencing factors of UTI in patients with diabetic neuropathy.
Methods: A hospital-based cross-sectional study that recruited patients with diabetic neuropathy was conducted from January 2019 to December 2021. Collected data included patient demographic information (age, sex, education level, body mass index), clinical data (duration of diabetes, method of administration), and laboratory tests. Multivariable logistic regression models were used to identify the factors associated with UTI risk. The strength of association was expressed as the odds ratio (OR) and 95% confidence interval (95% CI).
Results: A total of 579 patients were recruited (male, 68.2%; overall average age, 57.89 years). Using multivariate analysis with adjustment for confounding factors, female sex (odds ratio [OR]: 4.12; 95% CI: 2.24– 7.60; P < 0.001), hypodermic insulin injection (OR: 2.10; 95% CI: 1.02– 4.35; P = 0.045), chronic kidney disease (OR: 3.12; 95% CI: 1.11– 8.80; P = 0.032), history of UTI (OR = 45.92; 95% CI: 8.62– 244.76; P < 0.001), positive urinary nitrite (OR: 32.87; 95% CI: 7.37– 146.70; P < 0.001), and high residual urine volume (OR: 2.19, 95% CI: 1.17– 4.10; P = 0.014) were independent risk factors for UTI in patients with diabetic neuropathy. Compared with the patients aged < 45 years, UTI prevalence increased 2.91-fold in patients aged 45– 54 years (OR: 3.91; 95% CI: 1.02– 15.03; P = 0.047) and 3.87-fold in those aged ≥ 65 years (OR: 4.87; 95% CI: 1.23– 19.25; P = 0.024).
Conclusion: The main findings of this study showed that older age, female sex, hypodermic insulin injection, CKD, history of UTI, and positive urinary nitrite were independent risk factors for UTI in patients with diabetic neuropathy. To minimize the occurrence and resulting disease burden of UTI, knowledge regarding UTI risk factors in patients with diabetic neuropathy is critical to designate interventions.
Keywords: epidemiology, prevalence, urinary tract infection, diabetic neuropathy, risk factors