Recurrent Urinary Tract Infection in Diabetics: A Retrospective Analysis

Background Recurrent urinary tract infections (rUTIs) are a common complication in diabetic individuals due to impaired immune responses, poor glycemic control, and anatomical abnormalities. Objective Given the high burden of diabetes, rising antimicrobial resistance, and the paucity of local epidemiological data on recurrent UTIs in this population, this study aimed to determine the clinical characteristics, microbial profile, antibiotic resistance patterns, and associated risk factors of recurrent urinary tract infections in patients with diabetes mellitus. Methods This retrospective study was conducted at Fatima Memorial Hospital, Lahore, Pakistan from April 2023 to April 2025. A total of 320 patients with a confirmed diagnosis of diabetes and documented episodes of recurrent urinary tract infections were included in the study. Clinical and laboratory data were extracted from electronic and paper-based medical records using a standardized data collection form. Results The mean age of patients was 59.4 ± 11.2 years, with females comprising 218 (68.1%) of the cohort. Type 2 diabetes accounted for 286 (89.4%) of cases. Poor glycemic control (HbA1c > 7.5%) was observed in 229 (71.6%) of patients. The most common pathogen was E. coli (180, 56.3%), followed by Klebsiella pneumoniae (59, 18.4%) and Enterococcus faecalis (29, 9.1%). Multidrug resistance was noted in 146 (45.6%) of isolates; 118 (36.9%) were extended-spectrum beta-lactamases (ESBL) producers. Logistic regression identified female gender (OR: 2.84), poor glycemic control (OR: 3.12), diabetes duration >10 years (OR: 2.45), diabetic nephropathy (OR: 2.19), and prior UTI-related hospitalization (OR: 3.67) as significant predictors of recurrence and resistance (p < 0.05). Conclusion It is concluded that recurrent UTIs are common in diabetic patients and are significantly influenced by glycemic control, gender, disease duration, and renal complications. Rising antibiotic resistance among uropathogens necessitates routine culture-based treatment and individualized preventive strategies to improve outcomes in this high-risk group.