Asymptomatic pyuria and bacteriuria are not risk factors for urinary tract infection in women with type 2 diabetes mellitus initiated SGLT2 inhibitors

• Published in: International urology and nephrology 2024-03, Vol.56 (3), p.1165-1172
• Main Authors: Akkuş, Erman, Gökçay Canpolat, Asena, Demir, Özgür, Çorapçıoğlu, Demet, Şahin, Mustafa
• Format: Article
• Language: English
• Subjects: Asymptomatic; Asymptomatic Infections; Bacteriuria; Bacteriuria - complications; Bacteriuria - epidemiology; Cohort Studies; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Female; Females; Genital tract; Humans; Medicine; Medicine & Public Health; Nephrology; Nephrology - Original Paper; Prospective Studies; Pyuria; Pyuria - epidemiology; Pyuria - etiology; Risk factors; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Urinary tract; Urinary tract diseases; Urinary tract infections; Urinary Tract Infections - complications; Urinary Tract Infections - epidemiology; Urogenital system; Urology
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-023-03798-5

Purpose Asymptomatic pyuria and bacteriuria are more prevalent in diabetic patients and may be associated with urinary tract infection (UTI). The aim of this study is to investigate the association between asymptomatic pyuria/bacteriuria at the initiation of SGLT2 inhibitor and UTI risk in female patients with type 2 diabetes. Methods The study was designed as a practical, single-center, prospective, cohort study. The female outpatients with type 2 diabetes initiated SGLT2 inhibitor were included. Patients who were symptomatic or treated in the past 3 months for urinary or genital tract infection, had a high risk for UTI were excluded. Hospitalization/antibiotic use for indications other than UTI were exclusion criteria during follow-up. All patients were followed up for 3 months. Pyuria and bacteriuria were exposure and, UTI was the outcome. Cumulative incidence and relative risk of UTI were analyzed for pyuria and bacteriuria. Results 143 female patients were included among 1132 female type 2 diabetic patients. 13 patients were excluded during follow-up. 41.5% of the patients (n = 54) had pyuria and 28.5% (n = 37) had bacteriuria. The cumulative incidence of UTI was 20% in the whole cohort, 25,9% (n = 14/54) in the pyuria group and 18.9% (n = 7/37) in the bacteriuria group. The relative risk of UTI was 1.64 (95% CI: 0.82–3.26, p = 0.15) for pyuria, 0.92 (95% CI: 0.42–2.01, p = 0.84) for bacteriuria, and 1.2 (95% CI: 0.47–3.08, p = 0.69) for pyuria plus bacteriuria. Adjusted odd ratios revealed similar results. Conclusions Asymptomatic pyuria/bacteriuria at the initiation of SGLT2 inhibitors are not risk factors for UTI in women with type 2 diabetes.