Antimicrobial resistance patterns of Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections: a prospective study from a tertiary care hospital in Hyderabad
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252781Keywords:
Uropathogens, Antimicrobial resistance, Klebsiella pneumoniae, UTIAbstract
Background: Urinary tract infections (UTI) are among the most prevalent healthcare-associated infections (HAI), with E. coli and K. pneumoniae being the leading etiological agents. The increasing trend of antimicrobial resistance among these uropathogens threatens effective treatment, necessitating regular local surveillance. Therefore, the objective of this investigation is to assess the antibiotic resistance pattern among urinary isolates of E. coli and K. pneumoniae.
Methods: A prospective observational study was conducted from January to April 2025 in the department of microbiology at Apollo Institute of Medical Sciences and Research, Hyderabad. A total of 305 non-duplicate urine samples from UTI patients were processed. Isolates of E. coli and K. pneumoniae were identified using standard microbiological procedures. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method according to CLSI guidelines.
Results: Of the 305 samples, 88 (28.85%) were culture-positive for E. coli (60.2%) and K. pneumoniae (18.2%). E. coli isolates were predominantly recovered from patients aged 60–80 years and females (73.58%). K. pneumoniae was more frequent in the 20-40 years’ age group and also showed a female predominance (56.25%). High resistance was observed to third-generation cephalosporins, especially among E. coli. However, E. coli showed high susceptibility to fosfomycin (100%), nitrofurantoin (94%), and amikacin (92%). K. pneumoniae exhibited lower sensitivity overall, with highest susceptibility to amikacin (75%) and cotrimoxazole (75%).
Conclusions: The study represents E. coli and K. pneumoniae as major uropathogens with concerning resistance patterns, particularly to third-generation cephalosporins. These findings reinforce the need for routine antimicrobial resistance monitoring and evidence-based empirical therapy to optimize UTI management.
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Edin A, Tilahun D, Jara BA, Ayele A. Bacterial profile and antimicrobial susceptibility pattern of uropathogens among suspected patients attending Bule Hora University Teaching Hospital, southern Ethiopia. Front. Bacteriol. 2025;4:1439865. DOI: https://doi.org/10.3389/fbrio.2025.1439865
Govindarajan DK, Kandaswamy K. Virulence factors of uropathogens and their role in host pathogen interactions. The Cell Surface. 2022;8:100075. DOI: https://doi.org/10.1016/j.tcsw.2022.100075
Bhargava K, Nath G, Bhargava A, Kumari R, Aseri GK, Jain N. Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of Northern India. Front Microbiol. 2022;13:965053. DOI: https://doi.org/10.3389/fmicb.2022.965053
Huang L, Huang C, Yan Y, Sun L, Li H. Urinary Tract Infection Etiological Profiles and Antibiotic Resistance Patterns Varied Among Different Age Categories: A Retrospective Study From a Tertiary General Hospital During a 12-Year Period. Front Microbiol. 2022;12:813145. DOI: https://doi.org/10.3389/fmicb.2021.813145
Subedi M, Thapaliya S, Thapa S. Prevalence and Antibiotic Susceptibility Pattern of Uropathogens from Urinary Tract Infection Suspected Patients Visiting Tertiary Care Hospital of Nepal. Amrit Res J. 2024;5(1):114-21. DOI: https://doi.org/10.3126/arj.v5i1.73562
Gupta V, Rani H, Singla N, Kaistha N, Chander J. Determination of extended-spectrum β-lactamases and AmpC production in uropathogenic isolates of Escherichia coli and susceptibility to fosfomycin. J Lab Phys. 2013;5(02):090-3. DOI: https://doi.org/10.4103/0974-2727.119849
Taneja N, Rao P, Arora J, Dogra A. Occurrence of ESBL and Amp-C β-lactamases and susceptibility to newer antimicrobial agents in complicated UTI. Indian J Med Res. 2008;127(1):85-8.
Assuez A, Murali A, Rajan AK, George C, Nair CC, Beena P. A prospective study of antibiotic susceptibility pattern of uropathogens in a tertiary care hospital. World J Biol Pharmacy Health Sci. 2025;21(1):589-97. DOI: https://doi.org/10.30574/wjbphs.2025.21.1.0063
Behzadi P, Urbán E, Matuz M, Benko R, Gajdács M. The Role of Gram-Negative Bacteria in Urinary Tract Infections: current Concepts and Therapeutic Options. Adv Exp Med Biol. 2021;1323:35-69. DOI: https://doi.org/10.1007/5584_2020_566
Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Rev Microbiol. 2015;13(5):269-84. DOI: https://doi.org/10.1038/nrmicro3432
Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-20. DOI: https://doi.org/10.1093/cid/ciq257
Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin. 2014;28(1):1-13. DOI: https://doi.org/10.1016/j.idc.2013.09.003
Ranjan A, Shaik S, Mondal A, Nandanwar N, Hussain A, et al. Molecular epidemiology and genome dynamics of New Delhi metallo-β-lactamase-producing extraintestinal pathogenic Escherichia coli strains from India. Antimicrobial agents and chemotherapy. 2016;60(11):6795-805. DOI: https://doi.org/10.1128/AAC.01345-16
Rizvi M, Malhotra S, Agarwal J, Siddiqui AH, Devi S, Poojary A, et al. Regional variations in antimicrobial susceptibility of community-acquired uropathogenic Escherichia coli in India: Findings of a multicentric study highlighting the importance of local antibiograms. IJID Regions. 2024;11:100370. DOI: https://doi.org/10.1016/j.ijregi.2024.100370
Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev. 1998;11(4):589-603. DOI: https://doi.org/10.1128/CMR.11.4.589
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