The study had the approval of the Ethics Committee of the Olabisi Onabanjo University Teaching Hospital, Sagamu. All patients gave their informed consents. The study group consists of consecutive known diabetic patients with AB presenting at the Medical Out-Patient Department of the Hospital.

Following the 1985 WHO criteria, diabetes was defined as a fasting glucose concentration of 7.8mmol/l, a two-hour glucose concentration of ll.lmmol/1, or the use of glucose lowering medications (oral agents or insulin). We defined AB as the presence of at least 105 colony forming units/ml of lor 2 bacterial species in a culture of clean-voided urine from an individual without symptoms of a UTI. We defined contaminated urine as the presence of at least three different micro-organisms in one urine specimen. The inclusion criteria are a prior diagnosis of diabetes mellitus without recent symptoms of UTI (dysuria, frequency, fever, etc). These patients should also have received no therapy with antibiotics, non-steroidal anti-inflammatory drugs, and immunosuppressives in the preceding two weeks. The exclusion criteria include pregnancy, presence of cystic renal disease, recent hospitalization or surgery (within the past four months), recent instrumentation (within the past two months), known anatomic and neurologic urinary tract abnormalities, the presence of urinary symptoms (the presence of dysuria, frequency or urgency, strangury, abdominal discomfort, or fever) or recent use of antimicrobial drugs (within the previous two weeks).
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Clinical parameters including the age, gender, duration, drug therapy, clinical symptomatology—especially urinary complaints, last menstrual period (for female patients) were recorded. Fasting blood sugar and two-hour postprandial blood sugar (on two occasions) were estimated.

Mid-stream urinary specimens were collected for urinalysis, microscopy, culture, sensitivity and gram staining. All patients were asked to start with a full bladder. Female patients separated the labia using the left hand and cleansed the vulva from the front to the back with sterile swabs before passing urine. The sample was collected by plunging the sterile container into the urinary stream, without stopping the urine flow, with the right hand.

Male patients were required to clean the penis with a sterile swab, void half way and plunge the sterile container into the stream. The specimens were refrigerated (immediately after collection) and cultured within two hours.

All urine samples were cultured on Blood and MacConkey agar plates using standard platinum wire loop. The plates were incubated at 37° С aerobically for 24 hours. Cultures with colony counts > 105/ml were considered as significant bacteriuria. The organisms were identified using standard bacteriological techniques. Antimicrobial sensitivity was determined by the agar diffusion method using multodiscs (Abtek Biologicals Ltd., Liverpool, UK). Escherichia coli NCTC 6571 and staphylococcus aureus NCTC were used as controls. Urinalysis was performed using a dipstick (Medi-Test Combi 9 Macherey, Nagel, Germany).

A well-structured questionnaire was administered to each patient to obtain his or her demographic data, biodata, diabetic history, associated medical/surgical conditions and detailed urinary symptoms.

without recent symptoms of UTI (dysuria, frequency, fever, etc). These patients should also have received no therapy with antibiotics, non-steroidal anti-inflammatory drugs, and immunosuppressives in the preceding two weeks. The exclusion criteria include pregnancy, presence of cystic renal disease, recent hospitalization or surgery (within the past four months), recent instrumentation (within the past two months), known anatomic and neurologic urinary tract abnormalities, the presence of urinary symptoms (the presence of dysuria, frequency or urgency, strangury, abdominal discomfort, or fever) or recent use of antimicrobial drugs (within the previous two weeks).