Sir,
We read the article “Prevalence of lower urinary tract infection in South Indian type 2 diabetic subjects” by Janifer et al. with great interest. Diabetic patients with urinary tract infection is a common scenario in the nephrourology outpatient department. Treating them is a real challenge.[1] Here, we would like to highlight few important points. Firstly, fungal urinary tract infection in diabetic patients might be asymptomatic and should be sought in every diabetic patient with urinary tract infection.[2] Secondly, we feel that ultrasound-guided suprapubic aspiration of urine is useful in those patients with repeated contamination in urine culture report.[3] Thirdly, we believe that a minimum of 2 weeks of antibiotic therapy is necessary as eradication of the organism in diabetic patients is difficult. Improper duration of antibiotic will encourage resistance.[4] Fourthly, circumcision might be beneficial, especially in those patients who cannot maintain personal hygiene. We would like to know the author’s views regarding these points.
References
- 1.Bonadio M, Meini M, Gigli C, Longo B, Vigna A. Urinary tract infection in diabetic patients. Urol Int. 1999;63:215–9. doi: 10.1159/000030453. [DOI] [PubMed] [Google Scholar]
- 2.Krcmery S, Dubrava M, Krcmery V., Jr Fungal urinary tract infections in patients at risk. Int J Antimicrob Agents. 1999;11:289–91. doi: 10.1016/s0924-8579(99)00032-1. [DOI] [PubMed] [Google Scholar]
- 3.Titus MO, White SJ. Suprapubic bladder tap aspiration in an elderly female. J Emerg Med. 2006;30:421–3. doi: 10.1016/j.jemermed.2005.07.014. [DOI] [PubMed] [Google Scholar]
- 4.Geerlings SE. Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment. Int J Antimicrob Agents. 2008;31:S54–7. doi: 10.1016/j.ijantimicag.2007.07.042. [DOI] [PubMed] [Google Scholar]