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Suzanne E. Geerlings, MD, PhD; Ronald P. Stolk, MD, PhD; Marielle J. L. Camps, MD; Patrick M. Netten, MD, PhD; J. Theo Collet, MD; Peter M. Schneeberger, MD, PhD; Andy I. M. Hoepelman, MD, PhD

Arch Intern Med. 2001;161:1421-1427.

Background  Women with diabetes mellitus (DM) have asymptomatic bacteriuria (ASB) more often than women without DM. It is unknown, however, what the consequences of ASB are in these women.

Objective  To compare women with DM with and without ASB for the development of symptomatic urinary tract infections (UTIs), renal function, and secondary complications of DM during an 18-month follow-up period.

Methods  In this multicenter study we monitored women with DM with and without ASB for the development of symptomatic UTIs, renal function, and secondary complications (ie, retinopathy, neuropathy, microvascular, or macrovascular diseases). Data on the first 18-month follow-up period are presented.

Results  At least 1 uncontaminated urine culture was available from 636 women (258 with type 1 DM and 378 with type 2 DM). The prevalence of ASB at baseline was 26% (21% for those with type 1 DM and 29% for those with type 2 DM). Follow-up results were available for 589 (93%) of the 636 women. Of these 589 women, 115 (20%) (14% with type 1 DM and 23% with type 2 DM) developed a symptomatic UTI. Women with type 2 DM and ASB at baseline had an increased risk of developing a UTI during the 18-month follow-up (19% without ASB vs 34% with ASB, P = .006). In contrast, there was no difference in the incidence of symptomatic UTI between women with type 1 DM and ASB and those without ASB (12% with ASB vs 15% without ASB). However, women with type 1 DM and ASB had a tendency to have a faster decline in renal function than those without ASB (relative increase in serum creatinine level 4.6% vs 1.5%, P = 0.2).

Conclusion  Women with type 2 DM and ASB have an increased risk of developing a symptomatic UTI than those without ASB.

From the Department of Internal Medicine (Drs Geerlings, Collet, and Hoepelman), Division of Infectious Diseases and AIDS (Drs Geerlings and Hoepelman), the Julius Center for Patient Oriented Research (Dr Stolk), and the Eijkman Winkler Laboratory for Medical Microbiology (Dr Hoepelman), University Hospital, Utrecht; Department of Internal Medicine, Catharina Hospital, Eindhoven (Dr Camps); Department of Internal Medicine (Dr Netten) and the Laboratory of Medical Microbiology (Dr Schneeberger), Bosch Medicentrum's Hertogenbosch, the Netherlands.

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