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Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

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open access

Published: 14 September 2020

Antimicrobial Susceptibility Pattern of Urine Culture Isolates in a Tertiary Care Hospital of Karachi, Pakistan

Nida Hussain, Mahvesh Mahmud, Maryam Anwar, Ambreen Wasim

Ziauddin University, Pakistan

journal of social and political sciences
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Pages: 403-410

Keywords: Antimicrobial Susceptibility, Urine Culture Isolates, Tertiary Care, Hospital


Background: Urinary Tract Infections (UTIs) remain one of the leading causes of infection worldwide, andare a major health concern in developing countries, and lead patients to seek medical care. Recent reports have shown increasing resistance to commonly-used antibiotics. We aimed to study the isolates and their antibiotic resistance pattern in outpatients. Objective: The study was done in Karachi on outdoor patient urine samples, of patients with clinically suspected UTIs, in order to assess the antimicrobial susceptibility pattern of different organisms, which would help in deciding empirical antibiotic treatment and improving patient outcome. Materials and Methodology: 400 urine samples of patients clinically suspected to have UTI were collected directly from the bacteriology lab, out of which 77 were culture positive. The positive samples included 64 females and 13 males. Results: The most commonly isolated organism was Escherichia coli (E.coli), followed by Klebsiella species. Escherichia coli was most sensitive to meropenem and nitrofurantoin (96.6%) whereas Klebsiella species were sensitive to several antibiotics excluding cotrimoxazole and the fluoroquinolones. Conclusion: E.coli species is the most common organism causing UTIs. Antimicrobial resistance is emerging against some antibiotics, and the current susceptibility patterns may be used locally for optimum therapeutic outcomes and for preventing antibiotic misuse.


  1. Ejrnæs K., YEAR Bacterial characteristics of importance for recurrent urinary tract infections caused by Escherichiacoli. DanMedBull 2011;58:B4187.

  2. Matthew GB, Matthew AM. Persistence of uropathogenic Escherichia coli in the face of multipleantibiotics. Antimicrob Agents Chemother. 2010;54(5):1855–1863. doi:10.1128/AAC.00014-10

  3. Gupta P, Mandal J, Krishnamurthy S, Barathi D, Pandit N (2015) Profile of urinary tract infections in paediatric patients. Indian Med Res 141: 473-477.

  4. R N DasT S ChandrashekharH S JoshiM GurungN ShresthaP G Shivananda; Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal, Singapore Med J. 2006 Apr;47(4):281-5.

  5. Ihsan A, Zara R, Safia A, Sajid M, Javid ID. Prevalence of multi-drug resistant uropathogenic Escherichia coli in Potohar region of Pakistan. Asian Pac J Trop Biomed. 2016;6(1):60–66. doi:10.1016/j.apjtb.2015.09.022 [CrossRef] [Google Scholar]

  6. Alteri CJ, Mobley HL (2015) Metabolism and Fitness of Urinary Tract Pathogens. Microbiol Spectr vol 3.

  7. Hegde A, Bhat GK, Mallya S. Effect of exposure to hydrogen peroxide on the virulence of Escherichia coli. Indian J Med Microbiol 2008;26:25-8.  [PUBMED]

  8. Jharna M, Srinivas AN, Buddhapriya D, Subhash CP. Antibiotic resistance pattern among common bacterial uropathogens with a special reference to ciprofloxacin resistant Escherichia coliIndian J Med Res. 2012;136:842–849.

  9. Fair RJ, Tor Y. Antibiotics and bacterial resistance in the 21st century. Perspect Medicin Chem 2014;6:25-64.

  10. Moroh JLA, Fleury Y, Tia H, et al. Diversity and antibiotic resistance of uropathogenic bacteria from Abidjan. Afr J Urol. 2014;20:18–24. doi:10.1016/j.afju.2013.11.005

  11. Nickel JC. Management of urinary tract infections: Historical perspective and current strategies: Part 2 – modern management. J Urol 2005;173:27-32.  '

  12. Spoorenberg V, Hulscher ME, Akkermans RP, Prins JM, Geerlings SE. Appropriate antibiotic use for patients with urinary tract infections reduces length of hospital stay. Clin Infect Dis 2014;58:164-9.

  13. Sharma N, Gupta A, Walia G, Bakhshi R. Pattern of antimicrobial resistanceof Escherichia coli isolates from urinary tract infection patients: A three year retrospective study. J Appl Pharm Sci 2016;6:62-5.

  14. Changing antibiotic susceptibility pattern in uropathogenic Escherichia coli over a period of 5 years in a tertiary care center, Shobha PrasadaArchana BhatSevithaBhatShalini Shenoy Mulki, and Sanyuktha Tulasidas

  15. Alos JI (2005) Epidemiology and etiology of urinary tract infections in the community. Antimicrobial susceptibility of the main pathogens and clinical significance of resistance. Enfermedades Infecciosas Microbiologia Clinica 4: 3-8.

  16. McNulty CAM, Richards J, Livermore DM (2006) Clinical relevance of laboratory-reported antibiotic resistance in acute uncomplicated urinary tract infection in primary care. J Antimicrob Chemother 58: 1000-1008.

  17. Car J (2006) Urinary tract infections in women: diagnosis and management in primary care. British Medical Journal 332: 94-97.

  18. Tambekar DH, Dhanorkar DV, Gulhane SR, Khandelwal VK, Dudhane MN, et al. (2006) Antibacterial susceptibility of some urinary tract pathogens to commonly used antibiotics. Afr J Biotechnol 5: 1562-1565.

  19. Arpin C, Dubois V, Coulange L, Andre C, Fischer I ,Noury P et al. Extendspectrum s-lactamase producing Enterobacteriaceae in community and private health care centers. Antimicrob Agents Chemother 2003; 47: 3506-14.
    Aggarwal R, Chaudhary U, Sikka R. Detection of extended spectrum beta-lactamase production among uropathogens. J Lab Physicians 2004; 1: 7-10.
    Wiener J, Quinn J, Bradford P, Goering R, Nathan C, Bush K. Multiple antibiotic resistant Klebsiella and Escherichia coli in nursing homes. JAMA 1999; 281: 517-523.

  20. Nys S, van Merode T, Bartelds AIM, Stobberingh EE (2006) Urinary tract infections in general practice patients: diagnostic tests versus bacteriological culture. J Antimicrob Chemother 57: 955-958.

  21. Hazarika J, Baruah K, Urine culture isolates and their antibiotic sensitivity pattern in a Tertiary Care Hospital of North East India. PARIPEX-INDIAN JOURNAL OF RESEARCH, Volume : VII, Issue : VII, July – 2018,

  22. Nys S. Microbiology. Maastricht, The Netherlands: University Maastricht; 2005. Antibiotic resistance and commensal flora; pp. 142.

  23. George CE, Norman G, Ramana GV, Mukherjee D, Rao T. Treatment of uncomplicatedsymptomatic urinary tract infections: Resistance patterns and misuse of antibiotics. J Family Med Prim Care 2015;4:416-21.

  24. Prakash D, Saxena RS. Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of Meerut city, India. ISRN Microbiology2013;2013:749629.

  25. Somashekara SC, Deepalaxmi S, Jagannath N, Ramesh B, Laveesh MR, Govindadas D, et al. Retrospective analysis of antibiotic resistance pattern to urinary pathogens in a tertiary care hospital in South India. J Basic Clin Pharm 2014;5:105-8.

  26. Claudia V, Francesca L, Maria PB, Gianfranco D, Pietro EV, et al. (2014) Antibiotic Resistance Related to Biofilm Formation in Klebsiella pneumoniae 3: 743-758.

  27. Kashef N, Djavid GE, Shahbazi S (2010) Antimicrobial susceptibility patterns of community- acquired uropathogens in Tehran, Iran. J Infect Dev Ctries. 4: 202-206.

  28. Karlowsky JA, Jones ME, Thornsberry C, Critchley I, Kelly LJ, et al. (2001) Prevalence of antimicrobial resistance among urinary tract pathogens isolated from female outpatients across the US in 1999. Int J Antimicrob Agents 18: 121-127.

  29. Rajalakshmi V, Amsaveni V (2011) Antibiotic susceptibility of bacterial pathogens isolated from diabetic patients. International Journal of Microbiological Research 2: 273-275.

  30. Sharifian M, Karimi A, Tabatabaei SR, Anvaripour N (2006) Microbial sensitivity pattern in urinary tract infections in children: a single center experience of 1,177 urine cultures. Jpn J Infect Dis 59: 380-382.

  31. Haghi-Ashteiani M, Sadeghifard N, Abedini M, Soroush S, Taheri-Kalani M, et al. (2007) Etiology and antibacterial resistance of bacterial urinary tract infections in children’s medical center, Tehran, Iran. Acta Medica Iranica 45: 153-157.

  32. Rashed marandi FRM, Saremi M (2008) A survey on urinary pathogens and their antimicrobial susceptibility among patients with significant bacteriuria. Iran J Pathol 3: 191-196.

  33. World Health Organization. The World Health Report 1996. Geneva, Switzerland: World HealthOrganization;1996.Availablefrom: [Last accessed on 2018 Aug 01].

  34. World Health Organisation. National Action Plan on Antimicrobial Resistance (NAP-AMR) 2017-2021. New Delhi, India: World Health Organisation Country Office for India; 2017. Available from: [Last accessed on 2018 Aug 01].

  35. Laxminarayan R, Chaudhury RR. Antibiotic resistance in India: Drivers and opportunities for action.PLoS Med 2016;13:e1001974.

  36. Porter G, Grills N. Medication misuse in India: A major public health issue in India. J Public Health (Oxf) 2016;38:e150-7.

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