Antimicrobial susceptibility pattern of urine culture isolates in a tertiary care hospital of Jharkhand, India

Akhilesh Kumar, Rajiv Kumar, Manju Gari, Uma Shanker P. Keshri, Sumit K. Mahato, Kumari Ranjeeta


Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So, regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empirical therapy while managing UTIs. The purpose of the study was to identify different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in outpatient and indoor patients at RIMS, Ranchi, Jharkhand.

Methods: Observational study was conducted using urine culture and sensitivity reports collected retrospectively from records maintained in the department of Microbiology over a period from July 2016 to Feb 2017 in tertiary care hospital.

Results: UTI was more common in females (57.74%) than in males (42.26%). Among the uropathogens isolated Escherichia coli (37.41%) was found to be the predominant organism followed by Klebsiella species (32.79%), Pseudomonas species (25.86%), and gram-positive bacteria Staphylococcus aureus accounted (3.92%) of total cases. The most common isolates were E. coli showed high sensitivity to amikacin (79.24%), followed by levofloxacin (77.21%) and gentamycin (62.26%). It was found to be resistant to norfloxacin (86%), nalidixic acid (86.76%) and cefotaxime (69.88%).

Conclusions: Though various microorganisms are responsible for UTI. Escherichia coli species is the most common organism. Antimicrobial resistance has already emerged against many antibiotics, making empirical treatment of these infections challenging.


Antimicrobial susceptibility pattern, Bacterial isolates, Urine culture, Urinary tract infection

Full Text:



Ronald AR. The natural history of urinary infection in adults. Med Clin North Am. 1991;75:299-312.

Bano S, Tunio SA, Menom AA, Detho H, Bano R, Kumari K. Evaluation of antibiotic susceptibility patterns of uropathogens circulating in Hydrabad, Pakisthan. Khyber Med Univ J. 2014;6(3):110-5.

Biswas R, Rabbani R, Ahmed HS, Abdus M, Sarkar S, Zafrin N, et al. Antibiotic sensitivity pattern of urinary tract infection at a tertiary care hospital. Bangladesh Crit Care J. 2014;2(1):21-4.

Saint S. Clinical and economic consequences of nosocomial catheter related bacteriuria. Am J Infect Control. 2000;28:68-75.

Das RN, Chandrashekhar TS, Joshi HS, Gurung M, Shrestha N, Shivananda. P G Department. Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal. Singapore Medica Journal. 2006;47(4):281.

Nicole W, Jon DM. Deciphering Dysuria. Emerg Med. 2008;40(9):29.

Jenson BH, Baltimore RS. Infectious Diseases. Nelson Essentials of Pediatrics 5th edition. Elsevier Inc. 2006;522.

Abu SQ. Occurrence and antibiotic sensitivity of Enterobacteriaceae isolated from a group of Jordanian patients with community acquired urinary tract infections. Cytobios. 2000;101:15-21.

Strom BL, Collins M, West SL, Kreisberg J, Weller S. Sexual Activity, Contraceptive Use, and Other Risk Factors for Symptomatic and Asymptomatic BacteriuriaA Case-Control Study. Annals of internal medicine. 1987 Dec 1;107(6):816-23.

Ranjbar R, Haghi AM, Jafari NJ, Abedini M. The prevalence and antimicrobial Susceptibility of bacterial uropathogens isolated from paediatric patients. Iranian J Pub Health. 2009;38(2):134-8.

Amin M, Mehdinejad M, Pourdangchi Z. Study of bacteria isolated from urinary tract Infections and determination of their susceptibility to antibiotics. Jundishapur J Microbiol. 2011;2(3):118-23.

Sköld, O. Sulfonamides and trimethoprim. Exp. Rev. Anti-Infect. Ther. 2010;8(1):1-6. Available at

Wang H, Dzink-Fox JL, Chen M, Levy SB. Genetic characterization of highly fluoroquinolone-resistant clinical Escherichia coli strains from China: Role of acrr mutations. Antimicrobial Agents and Chemotherapy. 2001;45(5):1515-21.

Naber KG, Llorens L, Kaniga K, Kotey P, Hedrich D, Redman R. Intravenous doripenem at 500 milligrams versus levofloxacin at 250 milligrams, with an option to switch to oral therapy, for treatment of complicated lower urinary tract infection and pyelonephritis. Antimicrobial Agents and Chemotherapy. 2009;53(9):3782-92.

Karczmarczyk M, Martins M, Quinn T, Leonard N, Fanning S. Mechanisms of Fluoroquinolone Resistance in Escherichia coli Isolates from Food-Producing Animals. Applied and Environmental Microbiology. 2011;77(20):7113-20.

Khotaii Q, Mamishi S, Saligeh RN. Antibiotic resistance of germs isolated from urinary tract infections. Iran J Pediatr. 2002;12:28-32.

Al-Zahran AJ, Akhtar N. Susceptibility patterns of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolated in a teaching hospital, Pakistan Journal of Medical Research. 2005;44:64-7.

Al-Ali SM, Al-Hamdan AS, Al-Jark FA, Al-Faraj JMK, Mussalem SSA. Antimicrobial resistance pattern in urinary tract pathogens and its impact on empirical therapy in general practice, Kuwait Medical Journal. 2005;37(1):22-7.

Manges AR, Johnson JR, Foxman B, O'Bryan TT, Fullerton KE, Riley LW. Widespread distribution of urinary tract infections caused by a multi drug resistant Escherichia coli clonal group. New England Journal Medicine. 2001;345:07-1013.

Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cyctitis and acute pyelonephritis in women. J. Clinical infection Disease. 1999;29:745-58.

Jha N, Bapat SK. A study of sensitivity and resistance of pathogenic microorganism causing UTI in Kathmandu valley. Kathmandu Univ Med J. 2005;3:123-9.

Ronald A. The quinolones and renal infection Drugs, 1999;58:96-8. Available at:

Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med. 2002;113:14-9.

Dimitrov TS, Udo EE, Emara M, Awni F, Passadilla R. Etiology and antibiotic susceptibility patterns of community-acquired urinary tract infections in a Kuwait hospital. Med Princ Pract. 2004;13:334-3.

Akram M, Shahid M, Khan Au. Etiology and antibiotic resistance patterns Of Community- acquired urinary tract infections in JNMC Hospital Aligarh, India. Ann Clin Microbiol Antimicrob. 2007;23:6-4.

Papp-Wallace KM, Endimiani A, Taracila MA, Bonomo RA. Carbapenems: Past, Present, and Future. Antimicrobial Agents and Chemotherapy. 2011;55(11):4943-60.

Vuotto C, Longo, F, Balice MP, Donelli G, Varaldo, PE. Antibiotic Resistance Related to Biofilm Formation in Klebsiella pneumoniae. Pathogens. 2014;3(3):743-58.

Jarvis WR, Martone WJ. Predominant pathogens in hospital infections. J Antimicrob Chemother. 1992;29:19-24.

Matheson NR, Potempa J, Travis J. Interaction of a novel form of Pseudomonas aeruginosa alkaline protease (aeruginolysin) with interleukin-6 and interleukin-8. Biol Chem. 2006;387:911-5.

Lysczak JB, Cannon CL, Pier GB. Establishment of Pseudomonas aeruginosa infection: lessons from a versatile opportunist. Microbes Infect. 2000;2:1051-60.

Woods DE, Schaffer MS, Rabin HR, Campbell GD, Sokol PA. Phenotypic comparison of Pseudomonas aeruginosa strains isolated from a variety of clinical sites. J Clin Microbiol. 1986;24:260-4.

Barrett SP, Savage MA, Rebec MP, Guyot A, Andrews N, Shrimpton SB. Antibiotic Sensitivity of bacteria associated with community acquired urinary tract infection in Britain. J Antimicrob Chemother.1999;44:359-6.

Goldstein FW. Antibiotic susceptibility of bacterial strains isolated from patients with Community-acquired urinary tract infections in France. Eur J Clin Microbiol Infect Dis. 2000;19:112-7.

Musher DM, Mckenzie SO. Infections due to Staphylococcus aureus. Medicine. 1977;56:383-409.

Breitenbucher RB. Bacterial changes in urinary samples of patients with long-term indwelling catheters. Arch Intern Med. 1984;144:1585-8.

Nicolle LE, Muir P, Harding GKM, Norris M. Localization of urinary tract infection in elderly, institutionalized women with asymptomatic bacteriuria. J Infect Dis. 1988;157:65-70.

Jones JW, Carter A, Ewings P, O’Boyle PJ. An MRSA outbreak in a urolgy ward and its association with Nd: YAG coagulation laser treatment of the prostate. J Hosp Infect. 1999;41:3944.

Onanuga A. Antimicrobial resistance of S. aureus strains from patients with urinary tract infections in Yenagua, Nigeria. J. Of Phar and Bioallied Sci. 2012,Jul-Sept;4(3):226-30.

Olayinka BO, Olayinka AT, Onaolapo JA, Olurinola PF. Pattern of resistance to vancomycin and other antimicrobial agents in staphylococcal isolates in a university teaching hospital. Afr. Clin. Exper. Microbiol. 2005;6:46-52.

Beyene G, Tsegaye W. Bacterial uropathogens in urinary tract infection and antibiotic susceptibility pattern in JIMMA university specialized hospital, Southwest Ethiopia. Ethiopian Journal of Health Sciences. 2011;21(2):141-6.