Vol.64 No.5 September 2016
Association between urine glucose and a growth of bacterium and fungi
1)Department of Urology, Sapporo Medical University School of Medicine, S1, W16, Chuo-ku, Sapporo, Hokkaido, Japan
2)Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine
Abstract
The number of patients with diabetes mellitus (DM) is increasing in the world. The International Diabetes Federation reported that the prevalence rate of patients with DM in the world was 9.1% in 2015, and its ratio would increase more and more in the future. At the present, the renal sodium-glucose co-transporter2 (SGLT2) inhibitor, which is a new medication for DM, has been administered in Japan from 2014. SGLT2I is a receptor which is only located at the kidney proximal tubules of the kidney, which normally reabsorb the most glucose filtered through the glomeruli into the tubular cells. Since an over expression of this receptor in DM patients is one of the causes of hyperglycemia, administration of SGLT2I to such patients improves their blood sugar level by increasing the concentration of glucose in their urine.
One of the adverse events for DM patients for whom SGLT2I has been prescribed is the higher prevalence rate of urinary tract infection(UTI) and genital infection(GI) than those not taking SGLT2I. The main cause of such adverse events is thought to be the high concentration of glucose in their urine. Under this condition, several basic studies have speculated on the promotion of the abilities for growth of bacteria or fungus and for its adhesion to the urothelium in the host. Moreover, host immunity against microbes is known to decrease.
On the other hand, in the clinical setting, there is not always a significant association between the occurrence of bacteriuria or symptomatic UTI and urine glucose. One of the problems for this discrepancy is that we have not yet conducted and put in place well designed translational research to confirm the real answer for the relationship between UTI and DM. Thus, further study will be needed to clarify this, because the use of SGLT2I for DM patients could be expected to increase in the future.
Key word
bacterial growth, fungal growth, urine glucose, urinary tract infection, genital infection
Received
February 24, 2016
Accepted
March 8, 2016
Jpn. J. Chemother. 64 (5): 726-729, 2016
