Study Of Community and Nosocomial Uropathogens and Their Drug Resistance


  • Smita U Shevade Indira Gandhi Govt Medical College, Nagpur
  • Gopal N Agrawal Indira Gandhi Govt Medical College, Nagpur


Uropathogen, drug resistance, community-acquired UTI, nosocomial UTI


Background: Urinary tract infections (UTI) are amongst the most common infectionsencountered in clinical practice. Drug resistant uropathogenshas been increasingly observed, not only in nosocomial UTI but also in community-acquired (CA) UTI leaving very few options for the treatment. CA and nosocomial UTI differ aetiologically, epidemiologically; they also have different antibiotic resistance pattern. Therefore, we planned to study the bacterial aetiology and antibiotic susceptibility of uropathogens in CA and nosocomial UTI and compared them.

Methods: Uropathogens were isolated and identified as per standard microbiological techniques from urine samples of patients with CA and nosocomial UTI. The antibiotic susceptibility testing was performed as per clinical and laboratory standards institute (CLSI) 2012 guidelines.

Results: Amongst 1948 urine samples collected from UTI patients, 1697 (87.1%) were from the CA infections and 251 (12.9%) were from the nosocomial infections.E. coli was the most common organism isolated from both CA(60.1%) and nosocomial (33%)UTI. Non-fermenters, enterococci, candida were more common in nosocomial UTI. Resistance to routinely prescribed urinary antibiotics such as norfloxacin and cotrimaxazole was observed in CA strains of E. coli and klebsiella.In nosocomial uropathogens, in addition to cephalosporins and aminoglycosides, resistance to piperacillin-tazobactam and carbapenems was observed.Overall, drug resistance was more in nosocomial as compared to CA uropathogens.

Conclusion: The periodic update of local aetiology and antibiotic susceptibility of community and nosocomial uropathogens is necessary.


Ivancic V, Mastali M, Percy N et al. Rapid antimicro-bial susceptibility determination of uropathogens in clinical urine specimens by use of ATP biolumines-cence. J ClinMicrobiol 2008; 46:1213-9.

Gatermann SG. Bacterial infections of the urinary tract. In Borriello SP, Murray PR, Funke G (eds.). Top-ley& Wilson’s Microbiology & Microbial Infections, Vol. 1, 10th Ed, Hodder Arnold, Italy, 2005, p 672-83.

Wilson ML, Gaido L. Laboratory diagnosis of urinary tract infections in adult patients. Clin Infect Dis2004; 38: 1150-8.

Weber G, Riesenberg K, Schlaeffer F, Peled N, Borer A, Yagupsky P. Changing trends in frequency and anti-microbial resistance of urinary pathogens in outpa-tient clinics and a hospital in southern Israel, 1991–1995. Eur J ClinMicrobiol Infect Dis 1997; 16: 834–8.

Stamm WE, Counts GW, Running KR, et al. Diagno-sis of coliform infection in acutely dysuric women. N Engl J Med 1982; 307: 463–8.

Bronsema DA, Adams JR, Pallares R, Wenzel RP. Secular trends in rates and aetiology of nosocomial urinary tract infections at a university hospital. J Urol1993; 150: 414–6.

Chatterjee B, Kulathinal S, Bhargava A et al. Anti - microbial resistance stratified by risk factor among Escherichia coli strains isolated from the urinary tract at a rural clinic in Central India. Indian J Med Micro-biol 2009; 27:329-34.

Collee JG, Miles RS, Watt B. Tests for the identifica-tion of bacteria. In Collee JG, Fraser AG, Marmion BP, Simmons A (eds.). Mackie and McCartney Practical Medical Microbiology, 14th Ed, Churchill Livingstone, Delhi, 2007, p 131-49.

Performance standards for antimicrobial susceptibil-ity testing; Twenty-second informational supplement. CLSI 2012.

Stamm WE. Urinary tract infections, pyelonephritis, and prostatitis. In Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J (eds.). Harrison’s Principles of Internal Medicine, Vol. 2, 17th Ed, McGraw Hill, New Delhi, 2008, p 1820-7.

Hooton TM, Scholes D, Stapleton AE et al. A pro-spective study of asymptomatic bacteriuria in sexual-ly active young women. N Engl J Med 2000; 343:992-7.

Desai PJ, Pandit D, Mathur M et al. Prevalence, iden-tification and distribution of various species of enter-ococci isolated from clinical specimens with special reference to urinary tract infection in catheterized pa-tients. Indian J Med Microbiol 2001; 19:132-7.

Winn WC, Allen SD, Janda WM et al. Gram-positive cocci part II: Streptococci, enterococci and the “strep-tococcus-like bacteria”. In Koneman’sColor Atlas and Textbook of Diagnostic Microbiology, 6th Ed, Lip-pincott Williams & Wilkins, Philadelphia, 2006, p 672-764.

Tada DG, Gandhi PJ, Patel KN. A study on antibiotic related resistance in UTI patients: a comparison be-tween community acquired and hospital acquired E. coli. National Journal of Community Medicine 2012; 3: 255-8.

Patel S, Taviad PP, Sinha M, Javadekar TB, Chaudhari VP.Urinary tract infections (UTI) among patients at G. G. hospital & medical college, Jamna-gar. National Journal of Community Medicine 2012; 3: 138-41.




How to Cite

Shevade SU, Agrawal GN. Study Of Community and Nosocomial Uropathogens and Their Drug Resistance. Natl J Community Med [Internet]. 2013 Dec. 31 [cited 2024 Jun. 23];4(04):647-52. Available from:



Original Research Articles