Antimicrobial Susceptibility Sensitivity Pattern in Positive Urine Culture for Urinary Tract Pathogens from Tertiary Care Hospital
Hospital specific monitoring studies aims to determine the prevalence of the type of microorganisms that causes urinary infections and to assess the antimicrobial sensitivity pattern. A hospital based short term prospective cross-sectional study was conducted at Sagar Hospital, Bengaluru from August to October 2020. Antimicrobial susceptibility in MIC test was performed for the isolated pathogens by using automated VITEK compact method and stratification was done according to ICU and NON-ICU patients with over 260 urine culture tests of the suspected in-patient for urinary tract infection. All antimicrobial susceptibility data was analyzed using WHONET software 5.6. Sixty-six urine culture tests showed culture positive, 41 from non-ICU and 23 from ICU. Gram-negative bacilli E.Coli (61% in ICU, 52% IN non-ICU) was the most prevalent bacterium, followed by Klebsiella pneumoniae ss. pneumoniae (9% in ICU, 20% IN non-ICU), and Candida albicans 9% prevalence was seen only in ICU isolates. The study shows that the rate of resistance towards ampicillin (100%) was high among gram negative isolates and penicillin (100%) among gram positive isolates. The susceptibility was favorable towards polymixinB, colistin in gram negative organisms and nitrofurantoin, vancomycin in gram positive organisms. The present study revealed that E.Coli is the predominant bacterial pathogen. It also demonstrates there is an increasing resistance to ampicillin (88.2%) and ESBL (90%) among UTI pathogens. While, polymixin B (100%) and colistin was found most effective among gram negative and nitrofurantoin was most effective among gram positive organisms.
Keywords: Antibiotic, antimicrobial resistance, urinary tract infection
2. Gupta K, Sahm DF, Mayfield D, Stamm WE. Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in women: a nationwide analysis. Clinical infectious diseases. 2001 Jul 1; 33(1):89-94. https://doi.org/10.1086/320880
3. Nickel JC. Practical management of recurrent urinary tract infections in premenopausal women. Rev Urol. 2005 Winter; 7(1):11-7. PMID: 16985802; PMCID: PMC1477561.
4. Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Therapeutic advances in urology. 2019 Mar; 11:1756287219832172. https://doi.org/10.1177/1756287219832172
5. Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ. Detection of intracellular bacterial communities in human urinary tract infection. PLoS Med. 2007 Dec 18; 4(12):e329. https://doi.org/10.1371/journal.pmed.0040329
6. Nerurkar A, Solanky P, Naik SS. Bacterial pathogens in urinary tract infection and antibiotic susceptibility pattern. Journal of Pharmaceutical and Biomedical Sciences. 2012; 21(21). https://doi.org/10.4314/ejhs.v21i2.69055
7. Iso.org. 2021. Susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility test devices — Part 1: Broth micro-dilution reference method for testing the in vitro activity of antimicrobial agents against rapidly growing aerobic bacteria involved in infectious diseases. [online] Available at:
8. Skow MA, Vik I, Høye S. Antibiotic switch after treatment with UTI antibiotics in male patients. Infectious Diseases. 2020 Jun 2; 52(6):405-12. https://doi.org/10.1080/23744235.2020.1736329
9. Wang G, Hindler JF, Ward KW, Bruckner DA. Increased vancomycin MICs for Staphylococcus aureus clinical isolates from a university hospital during a 5-year period. Journal of clinical microbiology. 2006 Nov; 44(11):3883-6. https://doi.org/10.1128/JCM.01388-06
10. Rodloff A, Bauer T, Ewig S, Kujath P, Müller E. Susceptible, intermediate, and resistant–the intensity of antibiotic action. Deutsches Ärzteblatt International. 2008 Sep; 105(39):657-662. https://dx.doi.org/10.3238%2Farztebl.2008.0657
11. Beardsley JR, Williamson JC, Johnson JW, Ohl CA, Karchmer TB, Bowton DL. Using local microbiologic data to develop institution-specific guidelines for the treatment of hospital-acquired pneumonia. Chest. 2006 Sep 1; 130(3):787-93. https://doi.org/10.1378/chest.130.3.787
12. Kiem S, Schentag JJ. Relationship of minimal inhibitory concentration and bactericidal activity to efficacy of antibiotics for treatment of ventilator-associated pneumonia. InSeminars in respiratory and critical care medicine 2006 Feb (Vol. 27, No. 01, pp. 051-067). Copyright© 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. https://doi.org/10.1055/s-2006-933674
13. O’Rourke A, Beyhan S, Choi Y, Morales P, Chan AP, Espinoza JL, Dupont CL, Meyer KJ, Spoering A, Lewis K, Nierman WC. Mechanism-of-Action Classification of Antibiotics by Global Transcriptome Profiling. Antimicrobial Agents and Chemotherapy. 2020 Feb 21; 64(3). https://doi.org/10.1128/AAC.01207-19
14. Bush K, Jacoby GA. Updated functional classification of β-lactamases. Antimicrobial agents and chemotherapy. 2010 Mar; 54(3):969-76. https://doi.org/10.1128/AAC.01009-09
15. Gumbo T. Chapter 48: general principles of antimicrobial therapy. Goodman & Gilman’s the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill Medical. 2010.
16. Tandogdu Z, Cek M, Wagenlehner F, Naber K, Tenke P, van Ostrum E, Johansen TB. Resistance patterns of nosocomial urinary tract infections in urology departments: 8-year results of the global prevalence of infections in urology study. World journal of urology. 2014 Jun; 32(3):791-801. https://doi.org/10.1007/s00345-013-1154-8
17. Wilson ML, Gaido L. Laboratory diagnosis of urinary tract infections in adult patients. Clinical infectious diseases. 2004 Apr 15; 38(8):1150-8. https://doi.org/10.1086/383029
18. Mandal J, Acharya NS, Buddhapriya D, Parija SC. Antibiotic resistance pattern among common bacterial uropathogens with a special reference to ciprofloxacin resistant Escherichia coli. Indian J Med Res. 2012 Nov; 136(5):842-9. PMID: 23287133; PMCID: PMC3573607.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).