Abstract

Objective: Sodium-glucose cotransporter-2 inhibitors are used to treat diabetes by increasing glucose excretion into urine, leading to glycosuria. Although glycosuria increases risk of urinary tract infections, there is a lack of strong evidence showing such an increase with sodium-glucose cotransporter-2 inhibitor use.

Methods: Urine samples from Sodium-glucose cotransporter-2 inhibitor-exposed diabetic patients were inoculated with strains of E. coli (UTI89, LRPF007, and W3110), and bacterial growth was measured using changes in OD600.

Results: Change in OD600 was significantly higher for the nonpathogenic W3110 strain in diabetic patients with history of recurrent urinary tract infections compared to those with no or sporadic history of urinary tract infections. Conclusion: The two uropathogenic strains grew well in urine from all patient groups, possibly due to having defenses against the inhibitory factors in urine that prevent bacterial growth. Sodium-glucose cotransporter-2 inhibitor-exposed patients do not have more Urinary tract infections than the general population because they may have sufficient levels of inhibitory factors to prevent infection.