ABSTRACT:
Background: Urinary tract infection is the most common bacterial infection in women at all ages in general, and in postmenopausal women in particular.Several risk factors associated with recurrent UTI in postmenopausal women and especially diabetic. The aimof the studyto evaluate urinary tract infection UTI and factors associated with recurrent urinary tract infection in diabetics postmenopausal and relation with estrogen levelscompare with healthy. Patients and Methods: The study was conducted on 450postmenopausal women, attended the out patients clinic in Al-Batool Teaching Hospital, their ages more than 46 years, with mean age of (60±8years). Most of them suffering from UTI (256), working for her general urine examination, and according to presence of diabetes classified into, group1 included: 70 UTI with diabetes type-1 and 2, and group2: included 186without diabetes, (194) healthy postmenopausal women as control group during the period from February 2017 to January 2018 in Baquba city in Iraq. Urine and vaginal swabs were taken for culture on Blood agar and Mac Conkey agar, identified based on standard bacteriological methods. Measure vaginal pH by micrometer strips, all patients were examination Serum estradiol level. Questionnaire of all the patients including, presence of diabetes, and medical history of recurrent UTI, marital status, and antibiotics use. Results: The result of urine and vaginal swabs were taken for culture showed the positive bacterial growth were(68.57%), (52.68%) respectively in diabetes postmenopausal and without diabetes.Rate of Lactobacillussp. Associated with UTI among postmenopausal women with diabetes and without were (28.57%),(35.48%) respectively, in healthy women were(71.13%).Rate of bacterial species associated with UTI among postmenopausal women with diabetes and without were (47.91%), (38.77)for E. coli, and (31.25%), (28.57%) forKlebsiella sp., and (13.62 %),(21.05 %) for E. faecali, eachP. vulgaris andPseudomonas sp. were in rate (3.12% ) in diabetes and in rate (3.06%),(4.08%) in UTI without diabetes.The results of serum estradiol in patients with diabetes under 6 pg./ml, and approximately 9pg./ml in patients without diabetes, high value of vaginal PH in trend natural and alkaline conditions. In diabetic's premenopausal women with UTI, vaginitis, cystitis, and recent antibiotics use, according to medical history of UTI and marital status that play general role in diabeticpatients. Conclusion: We concluded increasing rates of UTI among diabetic's postmenopausal women that associated with several factors increase infection and recurrence, such as diabetes, maternity state, previous antibiotics use, and vaginal infections according to age and lower estrogen level that change vaginal flora.