Clinical Study on the Distribution Characteristics of Pathogens and Risk Factors for Urinary Tract Infections in Patients with Type 2 Diabetes Mellitus

Abstract

Objective : To clarify the distribution pattern of pathogens causing urinary tract infections (UTIs) in patients with type 2 diabetes mellitus (T2DM) and analyze the risk factors influencing the occurrence of infection, providing evidence-based guidance for precise clinical prevention and treatment. Methods : Clinical data from 191 patients with T2DM admitted to Guangxi-ASEAN Economic and Technological Development Zone People’s Hospital (The Tenth People’s Hospital of Nanning) from January 2024 to December 2025 were retrospectively collected. Patients were divided into an infection group (48 cases) and a non-infection group (143 cases) based on urine culture results. A microbial identification system was used to identify pathogens and perform drug susceptibility testing in the infection group. Differences in gender, age, glycated hemoglobin (HbA1c), and renal function-related indicators (creatinine, uric acid, urea, etc.) were compared between the two groups. Multivariate logistic regression analysis was used to identify independent risk factors for UTI. Results : The incidence of UTI among the 191 patients was 25.13% (48/191). A total of 50 pathogen strains were isolated from the infection group, including 38 strains (76.00%) of Gram-negative bacteria, predominantly Escherichia coli (29 strains, 58.00%); 7 strains (14.00%) of Gram-positive bacteria; and 5 strains (10.00%) of fungi. Drug susceptibility results showed that E . coli had high resistance rates to ampicillin and cefazolin but good sensitivity to imipenem and meropenem. Univariate analysis showed that levels of HbA1c, creatinine, and urea were significantly higher in the infection group than in the non-infection group (P < 0.05), while the endogenous creatinine clearance rate was significantly lower (P < 0.05). Multivariate logistic regression analysis indicated that HbA1c > 6.0% (OR = 3.862, 95% CI: 1.985 - 7.513, P < 0.001) and creatinine > 104.0 μmol/L (OR = 2.945, 95% CI: 1.528 - 5.678, P = 0.001) were independent risk factors for UTI in T2DM patients. Conclusion : The primary pathogen causing UTIs in T2DM patients is E . coli . Poor glycemic control and renal function impairment are key risk factors for infection. Clinically, monitoring and intervention for such high-risk patients should be strengthened, and antimicrobial agents should be selected rationally to improve prognosis.