IDENTIFICATION AND SUSCEPTIBILITY

OF BACTERIA CAUSING URINARY

TRACT INFECTION IN TERTIARY CARE
CENTRE
 INCRODUCTION
The most prevalent bacterial infection in the human population is urinary tract infection (UTI), and they account
for a major portion of the workload in clinical microbiology laboratories. A urinary tract infection, often known
as a UTI, is an infection that affects any portion of your urinary system, including your kidneys, bladder,
ureters, and urethra.

UTIs are categorized as uncomplicated or complicated in clinical terms. Uncomplicated UTIs usually affect
people who are generally healthy and don't have any anatomical or neurological problems with their urinary
system. Lower urinary tract infections (cystitis) and upper urinary tract infections (UTIs) are the two types of
infections (pyelonephritis). Females, a past UTI, sexual activity, vaginal infection, diabetes, obesity, and genetic
predisposition are all risk factors for cystitis. Urine blockage, urinary retention due to neurological illness,
immunosuppression, renal failure, renal transplantation, pregnancy, and the presence of foreign bodies such as
calculi, indwelling catheters, or other drainage devices are all examples of complicated UTIs.
 Materials and methods
• MICROSCOPY

• CULTURE

• ANTIBIOTIC SUSCEPTIBILITY TESTING

Antibiotics used
Amoxicillin, Ceftriaxone, Ampicillin, Cefazolin,
Chlorpheniramine, Ciprofloxacin, Levofloxacin, Imidazole,
Ciprofloxacin, Levofloxacin, Imidazole, Ciprofloxacin,
Levofloxacin, Imidazole, Ciprofloxacin, Levofloxacin,
Imidazole, Ciprofloxacin
Meropenem ,Amikacin ,Gentamicin ,Doxycycline ,Cotrimoxazol
e ,Nitrofurantoin ,Cefox,
Fosfomycin ,Ceftazidime ,Cefatrizine ,Tobramycin ,Vancomycin
,Teicoplanin for both Gram-positive and Gram-negative
bacteria.
 RESULT
Table 1. frequency of isolates identified from urine samples

Gram negative bacilli were the most prevalent isolates in this investigation, accounting for 88.1% of the total positive isolates. The most common gram-negative bacilli

isolate was E. coli (67.56%), followed by Klebsiella sp. (16.21%), Pseudomonas aeruginosa (10.81%), and Enterobacter (5.40%). Enterococcus was the most common
gram-positive bacteria (80%), followed by Staphylococcus aureus (20%).
Name of the isolates Frequency Percentage
 

  E. coli 25 67.56
   
  Enterobacter 2 5.40
   
Gram negative bacilli
Klebsiella spp. 6 16.21
N=37
 

Pseudomonas aeruginosa 4 10.81

 

Gram positive bacilli Staphylococcus aureus 1 20

N=5  

Enterococcus 4 80
 
 Table 2. Distribution of Antibiotic susceptibility amongst the bacterial isolate
Antibiotic susceptibility E.coli Klebsiella spp. Pseudomonas aeruginosa Enterobacter Enterococcus Staphylococcus aureus
(%)            
 
 

Ampicillin 12% 33.3%     100%  

Amoxicillin 32% 25%   50%    
Cefazolin 32% 66.6% 25% 50%    
Ceftriaxone 40% 83.3%   50%    
Chlorpheniramine 32% 83% 75% 50%    
Ciprofloxacin 28% 50% 100% 50%    
Levofloxacin   50% 100% 50%    
Imidazole 88% 83.3% 75% 50%    
Meropenem 96% 83.3% 100% 100%    
Piperacillin/tazobactam 100% 83% 100% 100%   100%
Amikacin 92% 50% 100% 100% 25% 100%
Gentamicin 84% 66.6% 100% 100% 25% 100%
Doxycycline 56% 66.6%     25% 100%
Co-trimoxazole 56% 83.3%        
Nitrofurantoin 76% 16.6%   50% 100%  
Fosfomycin 84%     50% 50%  
Ceftazidime   50% 25%   25%  
Cefatrizine     50%      
Tobramycin     50%      
Vancomycin         100% 100%
Teicoplanin         100% 100%
Linezolid         100% 100%
Cefox           100%
E. coli which was the predominant isolate gave high susceptibility to PIT (100%), Meropenem (96%), Amikacin
92%, Imidazole 88% and Gentamicin 84%. Klebsiella , the second most isolated organism, showed high
susceptibility to Ceftriaxone 83.3%, Imidazole 83.3% ,Meropenem 83.3%, Co-trimoxazole83.3% and
Chlorpheniramine 83.3%. Amongst Gram positive bacteria Enterococcus was commonest isolate showing
susceptibility to Ampicillin, Vancomycin, Teicoplanin, Linezolid.
 Table 3. Distribution of Antibiotic resistivity amongst the bacterial isolate
  E.coli Klebsiella spp. Pseudomonas aeruginosa Enterobacter Enterococcus Staphylococcus aureus
Antibiotic resistivity            
(%)
 

Ampicillin 80% 83.33%   100% 25%  

Amoxicillin 52% 66.6%   50%    
Cefazolin 48% 16.6%   50%    
Ceftriaxone 44%     50%    
Chlorpheniramine 40% 16.6%   50%    

Ciprofloxacin 64% 16.6%   50% 100% 100%

Levofloxacin 69% 33.3%   50% 100% 100%
Imidazole 8% 16.6% 25%      
Meropenem 40%          
pit   16.6%        
Amikacin            
Gentamicin 16%          
Doxycycline 28% 33.3%   50% 25%  
Co-trimoxazole 40%     50%   100%
Nitrofurantoin 20% 50%   50%   100%
Fosfomycin   66.6% 50% 50% 50%  
Ceftazidime     50%      
Cefatrizine            
Tobramycin            
Vancomycin            
Teicoplanin            
lz            
Cefox            
Conclusion

Since medication resistance among bacterial pathogens is a continuing phenomenon, periodic surveillance and 
monitoring are required to keep physicians abreast of the latest on the most effective and up-to-
date empirical therapy for UTIs.

Since these pathogens exhibit resistance to first-line medications used to treat UTI infections, periodic appraisal
of in vitro susceptibility patterns of urinary pathogens can serve as a guide for antibiotic treatment. 

To prevent or reduce the incidence of antibiotic resistance, anti-biotics should be used under medical

supervision and provided in appropriate dosages for an appropriate period of time.

 
THANK YOU