Bacteriology of community acquired urinary tract infection. Analysis of 1048 cases.

Urine samples from 1048 cases clinically suspected to have urinary tract infection were examined for bacteriological culture and antibiotic sensitivity. Of 1048 cultures, 530 (50.5%) were sterile, 163 (15.5%) showed the presence of nonpathogenic bacteria and 11 (1%) revealed nonsignificant bacteriuria with Escherichia coli. Significant bacteriuria (more than 10(5)/ml) was found in the remaining 344 (32.8%) cases. Escherichia coli was the predominant pathogen isolated from 170 (16.2%) samples; Klebsiella aerogenes was the next in order, found in 46 (4.3%) cases. Streptococcus pyogenes was isolated in 37 (3.5%), Pseudomonas aeruginosa in 29 (2.7%), Proteus mirabilis in 26 (2.4%), Streptococcus faecalis in 21 (2.0%), Staphylococcus aureus in 12 (1%) and Citrobacter freundii in 3 cases. Nalidixic acid was the most effective drug against gram negative organisms. Nitrofurantoin was the next antibiotic of choice, whereas cephalexin was the third drug in order of sensitivity. Ampicillin was the first drug of choice in infection with gram positive cocci, followed by nitrofurantoin, tetracycline, cephalexin and cephaloridine. The results of sensitivity tests emphasise the problem of multiple drug resistance in our community.