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ISSN: 2277-5536 (Print); 2277-5641 (Online)

BACTERIAL PROFILE AND ANTIBIOTIC RESISTANCE PATTERN OF
URINARY TRACT INFECTIONS
Barate D. L. and Ukesh C.S.
Department of Microbiology, Shri Shivaji College of Arts, Commerce and Science, Akola-444001 M.S., India ABSTRACT
Urinary tract infections remain a major medical problem occurring frequently and worldwide. Urinary tract
infections are one of the most important reasons for increased morbidity and healthcare expenditure. In present study
71(67.61%) women get affected by UTI while that of men the no. is 34(32.38%) which shows that women are more
prone to UTI than men. The Escherichia coli were found to be the predominant organism (49.52%) followed by the
Klebsiella pneumoniae (20.95%), Pseudomonas aeruginosa (15.23%), Proteus spp. (9.52%) and Staphylococcus
aureus (6.66%). The present study showed that most of the uropathogens were highly resistant to Ampicillin and
Amoxyclav while resistance pattern to the other antibiotics vary with the organisms. It is quite serious problem that
most of the uropathogens included in study showed multiple drug resistance.
KEY WORDS: multiple drug resistance, Urinary tract infections, uropathogens
INTRODUCTION
Urinary tract infection (UTI) defines a condition in which the urinary tract is infected with a pathogen causing
inflammation. Infection of the urinary tract is a common, distressing and occasionally life threatening condition. The
clinical features, diagnosis, treatment, complications and long term significance vary depending upon the site of
infection and various factors.
UTI is one of the most common diseases, occurring from the neonate up to the geriatric age group. It also contributes
the most common nosocomial infection in many hospitals and accounts for approximately 35% of all hospital acquired
infections. It also responsible for increased morbidity and economic cost. Bacteria are the primary organisms that cause
UTI. Among all, Gram negative bacteria are predominant and accounts for 80-85% while Gram positive for 15-20%.
Escherichia coli is the frequent pathogen but in complicated UTI the prevalence of other antibiotic resistant organisms
increases such as Klebsiella, Proteus, Serretia, Enterobacter, Pseudomonas, S. aureus, Bacillus etc.(Nadia et al.,2004).
Increasing antimicrobial resistance in bacterial pathogens is of worldwide concern. The prevalence of antimicrobial
resistance in both out and hospitalized patients with UTI is increasing and can vary according to geographical and
regional locations (Khan and Zaman, 2006). This is due to the fact that antibiotics are given empirically before the
laboratory results of urine culture are available to ensure the appropriate therapy (Khadri, 2009). In order to treat UTI
with a rational empirical therapy, it is necessary to identify the bacterial spectrum and antimicrobial susceptibilities of
the uropathogens. (Shigemura et al., 2005). The present study is one of the approaches to know the trends of occurrence
and resistance pattern among the uropathogens in the Akola city.

MATERIALS AND METHODS
The present study includes examination of 135 samples of urine from urinary tract infected patients of various
hospitals. Fresh midstream urine samples were collected in sterile containers. Each sample was inoculated on Cystein
Lactose Electrolyte Deficient agar plates using a calibrated loop delivering 0.01ml of the sample. The plates were
incubated at 37oC for18-24hrs. The plates showing >105 CFU/ml were considered as significant bacteriuria as per the
Kass count (Kass, 1956). Further the uropathogens were identified by their morphological and biochemical
characteristics.
The antibiotic sensitivity of isolated uropathogens was tested using Muller Hinton agar by Kirby-Bauer method. The
antibiotics used for the study were Ampicillin (10mcg), Amoxyclav (30mcg), Tetracycline (30mcg), Cephalexin
(10mcg), Norfloxacin (10mcg), Ciprofloxacin (5mcg), Gentamycin (10mcg), Erythromycin (15mcg), Chloramphenicol
(30mcg), Nalidixic acid (30mcg), Nitrofurantoin (50mcg).
RESULTS AND DISCUSSION
The 135 samples collected, 30 samples were excluded from study due to contamination and some with insignificant
bacteriuria. A total of 105 samples analyzed in the study shows 71(67.61%) of women get affected by UTI while that of
men the no. is 34(32.38%) which shows that women are more prone to UTI than men. The results shown in the Table
1-3 and Figure 1-3. The table 1 shows the data of age and sex wise distribution of UTI in different groups. In our study
more incidences were found for age group more than 40 years. This might be due to various physiological and
immunological changes occur in this age persons.

DAV International Journal of Science Volume-1, Issue-1 January, 2012

ISSN: 2277-5536 (Print); 2277-5641 (Online)


Table- 1. Age and sex wise distribution of 105 cases of UTI.
Age group
Total No.
Female (%)
Table- 2. Organisms isolated from urine samples
Name of Organism
Frequency
Percent (%)

Table-3. Antibiotic resistance pattern among uropathogens
% of isolates resistance to antibiotics
Antibiotics
Escherichia
Klebsiella
Pseudomonas
Proteus
Staphylococcus
coli
pneumoniae
aeruginosa
aureus
Age and sex wise distribution of UTI
No. of patients 15
Age group
Figure- 1. Age and sex wise distribution of 105 cases of UTI.

DAV International Journal of Science Volume-1, Issue-1 January, 2012

ISSN: 2277-5536 (Print); 2277-5641 (Online)

Bacterial profile of uropathogens
ercent
P 10
Organisms from urine samples
Figure-2. Bacterial profile of uropathogens.
Antibiotic resistance pattern among uropathogens
ates resistant
Antibiotics
Figure-3. Antibiotic resistance pattern among uropathogens.

In our study the bacterial profile of prevalent uropathogens causing UTI also studied and is shown into table 2. The
Escherichia coli were found to be the predominant organism (50; 49.52) followed by the Klebsiella pneumoniae (22;
20.95), Pseudomonas aeruginosa (16; 15.23), Proteus spp. (10; 9.52) and Staphylococcus aureus (07; 6.66).
The antibiotic resistance pattern amongst the isolated uropathogens were also determined and depicted in table 3.
Results showed that E coli, Klebsiella and Pseudomonas were highly resistant to most of the antibiotics used such as
Ampicillin, Amoxyclav, Tetracycline, Cephalexin, Norfloxacin, Ciprofloxacin, Gentamycin, Erythromycin,
Chloramphenicol, Nalidixic acid, Nitrofurantoin. Few of the isolates of Klebsiella pneumoniae had less resistance to
Nitrofurantoin, Norfloxacin, Ciprofloxacin and Chloramphenicol. While in some isolates of Pseudomonas showed less
resistance towards Gentamycin, Chloramphenicol and Ciprofloxacin. Among Proteus spp. high resistance were found
against Ampicillin, Amoxyclav, Cephalexin and Nitrofurantoin while in Gram positive S. aureus maximum resistance
were found to Ampicillin, Amoxyclav, Cephalexin and less resistance towards other antibiotics.
DISCUSSION
Urinary tract infections are mainly due to the invasion of pathogens belonging to the family Enterobacteriacae into the
urethra bladder and kidneys. The prevalence of UTI is higher among women than men and was reported by various
studies (Khan et al. 2004; Kumar et al. 2006). Our studies also showed higher i.e. 67% of women affected by UTI. This
might be due to the anatomical predisposition.
E. coli was found to be the most predominant (49.52%) organism followed by Klebsiella pneumoniae (20.95%) causing
UTI in our study which also in concordance with the study of Tankhiwale et. al. which reported E. coli 49.8% and
Klebsiella37.8%. The other organisms as Proteus spp. and S. aureus was found to be 9.52% and 6.66% respectively
which also observed to be similar with other (Hussain et al., 2005). Antibiotic resistance is a major clinical problem in
treating infections caused by these microorganisms. The resistance to the antimicrobials has increased over the years

DAV International Journal of Science Volume-1, Issue-1 January, 2012

ISSN: 2277-5536 (Print); 2277-5641 (Online)

and the resistance rates vary from country to country (Gales, 2001). Our data demonstrated that E. coli and Klebsiella
were highly resistant to Ampicillin i.e. 83% and 81% respectively. These findings are similar to the previous findings
(Kahlmeter, 2003; Khadri, 2009). In this study E. coli were resistant to most of the antibiotics as Ampicillin,
Amoxyclav, Tetracycline, Cephalexin, Gentamycin, Nalidixic acid Nitrofurantoin, ciprofloxacin, erythromycin which
in concordance with other studies (Khan et al., 2006; Rawat et al., 2010). Klebsiella pneumoniae was also exceedingly
resistant to Ampicillin (81%) and Amoxyclav (88%) This high resistance to these drugs also seen in other studies of
Akram et al. (2007) and Manjunath et al. (2011).

Pseudomonas aeruginosa Showed different patterns of resistance than that of the other organisms more resistance was
seen for Ampicillin (90%), Amoxyclav (70%), Cephalexin (80%), Norfloxacin (71%) and Nalidixic acid (72%)
somewhat similar findings were reported by others (Rahman et al., 2009) while in comparison isolates of Proteus spp.
and S. aureus besides showing high resistance to Ampicillin, Amoxyclav, Cephalexin had less resistance to other
antibiotics used.
The present study showed that most of the uropathogens were highly resistant to Ampicillin and Amoxyclav while
resistance pattern to the other antibiotics vary with the organisms. It is quite serious problem that most of the organisms
included in the study from UTI found resistant to multiple drugs. Antibiotic resistance has been emerged as the major
problem in the uropathogenic organisms so treatment of UTI should not be advocated without urine culture and
sensitivity performed. This would be helpful in proper treatment and preventing further development of resistant
strains.
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