Prevalence and antimicrobial susceptibility of uropathogens in patients reporting to a tertiary care facility in Peshawar, Pakistan

This study was conducted to assess the frequency and antimicrobial susceptibility pattern of bacteria in urinary isolates. The study was carried out in the clinical microbiology laboratory of a tertiary care hospital in Peshawar, Pakistan. The duration of study was 12 months, from July 2012 to June 2013. Mid-stream urine samples were collected in sterile containers. All samples for urine culture were examined. Samples were processed and microbial isolates were identified by standard methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method. Frequency of cultures proven urinary tract infection (UTI) cases in our study was 17.9% with Escherichia coli being the most common pathogen followed by Citrobacter freundii, Klebsiella oxytoca and Enterobacter cloacae. For E. coli, only 2% of the organisms were resistant to imipenem. For C. freundii, 9% of isolates were resistant to amikacin. For K. oxytoca, the most effective antibiotic was amikacin, with 100% sensitivity. Most common isolate was E. coli which was mostly sensitive to nitrofurantoin, amikacin and gentamicin. The drug of choice for oral empirical therapy for UTI in our setup is nitrofurantoin as bacteria were quite resistant to ampicillin, ciprofloxacin and cotrimoxazole. The best parental empirical therapies are amikacin and gentamicin.   Key words: Antibiotics, antimicrobial resistance, Escherichia coli, uropathogens.