Resistance Patterns of Urinary Tract Pathogens Isolated from Patients with Type 2 Diabetes Mellitus on Sodium Glucose Co-transporter 2 Inhibitors Admitted in a Tertiary Hospital in the Philippines

A Single-Center Retrospective Cohort Study

Abstract

Background. Congruent with the increasing prevalence of diabetes, a growing armamentarium of anti-diabetes medications has been introduced. Among these are sodium glucose co-transporter-2 inhibitors (SGLT2i). 

Objectives. SGLT2i use has been linked to an increased incidence of urogenital infections. The study aims to compare resistance patterns of urinary tract isolates among patients with diabetes who are on SGLT2i and not on SGLT2i.

Methodology. Single-center retrospective cohort study. A total of 464 patients (75 on SGLT2i, 389 not on SGLT2i) with DM type 2 and urinary tract infection were included. Urine culture results were compared.

Results. A similar pattern of urinary tract isolates was found between groups except for C. albicans being more common in the SGLT2i group. There was no significant association between the presence of resistant urinary tract pathogens and the use of SGLT2i. There was no statistically significant difference in resistance rates between groups, except for Imipenem (p = 0.015).

Conclusion. SGLT2i use per se does not play a pivotal role in mediating bacterial resistance in urinary tract pathogens among patients with DM type 2. We do not recommend for or against the use of specific antimicrobials based on SGLT2 inhibitor alone. Patient’s clinical profile along with urine culture test results remain key factors in patient management.