title: Characteristics and Antibiotic Resistance of Urinary Tract Pathogens Isolated From Punjab, Pakistan.
abstract: BACKGROUND
  Urinary tract infection (UTI) is deemed the most prevalent infectious disease in that it has now touched the overall incidence of 18/1000 persons per year in the general population.
  
  
  OBJECTIVE
  This study sought to determine the characteristics of isolates from patients with UTI and their susceptibility to commonly used antibiotics in Punjab, Pakistan.
  
  
  METHODS
  Totally, 1429 urine samples were analyzed from UTI patients for the isolation of uropathogens at Chughtai's Lahore Lab, Lahore, Pakistan, during a period of 14 months. The antimicrobial susceptibility test was performed via the disc diffusion method for the isolates obtained from 392 (26%) positive cultures.
  
  
  RESULTS
  The highest percentage (67%) of isolates was from females in comparison to males (33%). The frequency of Escherichia coli was the highest (62%) in culture-positive urine samples, followed by E. faecalis (15%), Candida (14%), Pseudomonas (6%), Klebsiella spp. (1%), Proteus (1%), and Staphylococcus aureus (1%). E. coli was highly resistant to antimicrobial drugs, viz. cephalexin (95%), cephradine (95%), pipemidic acid (92%), amikacin (91%), and nalidixic acid (91%). Most of the routine β-lactam antibiotics like amoxicillin/clavulanic acid, ampicillin, and aztreonam were also ineffective against E. coli, with resistance rates of 84%, 84%, and 72%, correspondingly. This pathogen showed maximum susceptibility (97%) against three drugs, namely imipenem, meropenem, and cefoperazone. Piperacillin and fosfomycin also provided significant results against E. coli with respective susceptibility rates of 96% and 90%.
  
  
  CONCLUSIONS
  Our results showed that broad-spectrum antibiotics such as imipenem, meropenem, fosfomycin, cefoperazone/sulbactam, and vancomycin would be the first line and the most effective drugs for the empirical treatment of urinary tract pathogens due to their higher resistance rates against other drugs like cephalexin, cephradine, ciprofloxacin, levofloxacin, and norfloxacin.
authors.affiliation: Department of Microbiology and Molecular Genetics, Quaid-e-Azam Campus, University of the Punjab, Lahore-54590, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Sohail
authors.affiliation: College of Allied Health Professionals, Directorate of Medical Sciences, Government College University, Faisalabad, Pakistan.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Khurshid
authors.affiliation: Department of Microbiology and Molecular Genetics, Quaid-e-Azam Campus, University of the Punjab, Lahore-54590, Pakistan.
authors.forename: Hafiz Ghulam Murtaza
authors.initials: HG
authors.lastname: Saleem
authors.affiliation: Department of Microbiology and Molecular Genetics, Quaid-e-Azam Campus, University of the Punjab, Lahore-54590, Pakistan.
authors.forename: Hasnain
authors.initials: H
authors.lastname: Javed
authors.affiliation: Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdul Arif
authors.initials: AA
authors.lastname: Khan
keywords: Antimicrobial Drugs; Escherichia coli; Urinary Tract Infections