Changing Etiology of Urinary Tract Infections and Emergence of Totally Resistant Uropathogens in and around Nanded (Maharashtra) A Seven-Year Study

Bhausaheb Munde, Suresh Kandle, Vimal Rathod, Vijayraj Shegokar, Supriya Emekar, Prerana Lahane


Background: Urinary tract infections (UTIs) remain the most common bacterial infections in developing countries. Knowledge of susceptibility pattern of uropathogens in a specific geographical location is an important factor for choosing suitable antibacterial treatment.

Objectives: A study was undertaken to ascertain the spectrum of causative agents responsible for UTIs and to determine the magnitude of drug resistance among them.

Results: A total of 1806 organisms were isolated from 3559 urine samples studied during 2010–2016. There is a shift in causative agents of UTI. Escherichia coli have been reappearing and replacing the current pathogen Klebsiella. Coagulase-positive Staphylococci have been significantly replaced by coagulasenegative Staphylococci. Other Gram-negative bacilli belonging to Proteus and Pseudomonas, which were supposed to be major pathogens of UTI particularly in tertiary care hospitals, are surprisingly being less encountered recently. It has been observed that 55.48% of strains were resistant to the antibiotics tested and there was sudden increase in incidence of totally resistant uropathogens during the year 2014. Majority of the totally resistant strains could be seen with Klebsiella (66.23%) followed by Citrobacter (63.28%).

Conclusion: These observations indicate extremely high degree of resistance in uropathogens and warrant change in the antibiotic usage as well as formulation of policy for rational use of antibiotics to reduce the
emergence of drug resistance in future.


Totally Resistant Bacteria, UTI

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Pattn JP, Nash DB, Abrutyn E. Urinary tract infections:

economic considerations. Med Clin. Nor. Am 1991;

(49): 5513-0.

Gales AC, Sader HS, Jones RN. The SENTRY Participants

Group (Latin America). Urinary tract infection trends

in Latin American hospitals: Report from the SENTRY

antimicrobial surveillance program (1997-2000). Diagn

Microbiol Infect Dis 2002; 44: 289-99.

Raghubanshi BR, Shrestha D, Chaudhary M et al.

Bacteriology of UTI in paediatric patients at KIST

medical college teaching Hospital. J of Kathmandu

Med Coll 2014; 3(1) 7: 21-25.

Maskell R. Paed L, Sandeson RA. Fastidious bacteria

and urethral syndrome: A two year Clinical and

bacteriological study of 51 women. Lancet 1983; 2:


Gupta V, Yadav A, Joshi RM. Antibiotic resistance

pattern in uropathogens. Indian J Med Microbiol 2002;

: 96-98.

Mokta KK, Jatinder K, Mokta JK et al. Bacterial etiology

and antibiotic susceptibility pattern of UTI in sub-

Himalayan region of India- A retrospective study of

clinical isolates. National Journal of Medical and Allied

Sciences 2015; 4(1): 38-45.

Razak SK, Gurushantappa V. Bacteriology of urinary

tract infection and antibiotic susceptibility pattern in

a tertiary care hospital in south India. International

Journal of Medical Science and Public Health 2012;

(2): 109-12.

Manjula NG, Math GC, Patil SA et al. Incidence of

urinary tract infections and its aetiological agents

among pregnant women in Karnataka region. Advances

in Microbiology 2013; 3: 473-78.

Stamm WE. Measurement of Pyuria and its relationship

of bacteriuria. AM J Med 1983; 75: 53-58.

Kunin CM. Detection, prevention and management

of urinary tract infections Ed. Lea and – Philadelphia.

Pappas PG. Laboratory in the diagnosis and

management of urinary tract infections. Med. Clin.

Nor. Am 1992; 75: 213-25.

Betty AF, Daniel FS, Alice SW. Overview of bacterial

identification and strategies. In: Bailey and Scott’s

Diagnostic Microbiology. 12th ed. Philadelphia: Mosby

; 216-47.

Matthew AW, Franklin RC, William AC et al. Performance

standards for antimicrobial disc susceptibility test,

Approved standard in Clinical and Laboratory Standards

Institute (CLSI). M2-A9. 9th ed. Pennsylvania: Wayne

; 26.

Stamm WE. Protocol for the diagnosis of urinary tract

infection: Reconsidering the criterion for significant

bacteriuria, Urology 1988; 32: Suppl (2): 6-12.

Wilkie ME, Almond MK, Marsh FP. Diagnosis and

management of urinary tract infection in adults. Br.

Med. Jour 1992; 305: 1137-40.

Farmer JJ III, Kelly MT. Enterobacteriacea. In Manual

of Clinical Microbiology, 5th Ed. Balows et al. eds.

Washington: American Society for Microbiology 1991;

Varma NC, Taneja GP, Saxena SN. Recurrent urinary

tract infections in females. J. Ind. Med. 1972; 58: 155-

Bajaj JK, Karyakarte RP, Kulkarni JD et al. Changing

etiology of UTI and emergence of drug resistance as

a major problem. J. Commun. Dis 1999; 31(3): 181-84.


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