Tariq Butt, Abdul Hannan, Karamat Ahmed Karamat.
Changing Pattern of Prevalence and Susceptibility of Various Urinary Isolates in Rawalpindi / Islamabad.
Pak Armed Forces Med J Nov ;45(2):87-94.

A number of 7585 microorganisms isolated from urine specimens between Jan 1989 and Dec 1993, at Armed Forces Institute of Pathology , Rawalpindi, were tested for their susceptibility to various antimicrobials. The disk diffusion technique (Kirby Bauer Method) using sensitest agar (Oxoid) (alone and/or with 5% horse blood) was adopted for various isolates against different antimicrobials. Escherichia coli remains the most common (46.96%) isolate, followed by pseudomonas aeruginosa (13.05%) and Klebsiella pneumoniae (12.99%). There was no significant change in the rate of isolation of most of the organisms. However, there is decrease in isolation of Klebsiella pneumoniae from 1989 (20.07%) to 1993 (12.99%) and increase in isolation of Staphylococcus aureus (3.81% 9.80%) and streptococcus (Enterococcus) faecalis (0.55 to 4.81%). Resistance of Escherichia coli against co-trimoxazole (COT) and ampicillin (AMP) has increased respectively from 40.32% and 39.65% (1989) to 76.18% and 77.98% (1993). Resistance of Pseudomonas aeruginosa against ofloxacin (OFL) has increased from 46.3% (1989) to 60.83°h (1993). Resistance of Klebsiella pneumoniae against nitrofurantoin (NIT) and norfloxacin (NOR) has increased respectively from 60% and 4.5% (1989) to 79.17% and 19.91% (1993). Resistance of Staphylococcus aureus against AMP has increased from 86.85% (1989) to 95.09% (1993). In 1993, all the isolates (excluding Pseudomonas aeruginosa and S. faecalis) revealed resistnace against NIT, 32.17% NOR, 20.31%; pipernedic acid, 37.19% COT, 78.68%; AMP, 86.83%; cephradine, 35.15% ; gentamicin, 32.24%; OFL, 14.19% and ceftriaxone, 20.16%. It appears that AMP and COT should not be used empirically in urinary tract infection (UTI) and instead NIT or NOR may be preferred as empirical treatment of UTI.

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