Original articles

Hospital and community isolates of uropathogens at a tertiary hospital in South Africa

Samukeliso Dube, Temnewo Habte, Nazir Ismail, Anwar Ahmed Hoosen


This study investigated the profile of common uropathogens isolated from urine specimens submitted to the diagnostic Microbiology Laboratory at a tertiary teaching hospital and assessed their antimicrobial susceptibility patterns to commonly used antimicrobial agents. We did a retrospective analysis of laboratory reports for all urine specimens submitted for investigations over a one year period. Isolates were tested for susceptibility using the Kirby Bauer disc diffusion method to amoxicillin, ciprofloxacin, gentamicin, co-trimoxazole, nitrofurantoin, and for ESBL production.
Out of the total specimens (n=2203) received over the one year study period, 51.1% (1126) of the urine samples were culture positive, the majority (65.4%) being from females. The commonest isolate was Escherichia coli (39.0%) followed by Klebsiella species (20.8%) and Enterococcus faecalis (8.2%). The Gram-negative isolates displayed a very high level of resistance to amoxicillin (range 43% – 100%) and co-trimoxazole (range 29% - 90%), whereas resistance to gentamicin (range 0% - 50%) and ciprofloxacin (range 0% - 33%) was lower. E coli isolates were susceptible to nitrofurantoin (94%) and ESBL production was significantly higher (p = 0.01) in the hospital isolates compared to those from the community referral sites.
The culture positive rate for uropathogens was high with the majority being from females. E coli was the commonest aetiological agent identified and remains susceptible to nitrofurantoin. Resistance levels to amoxicillin and co-trimoxazole are very high for all Gram negative isolates and it is recommended that these antibiotics should not be used for the empiric treatment of urinary tract infections.

Authors' affiliations

Samukeliso Dube, University of Limpopo

Temnewo Habte,

Nazir Ismail, University of Pretoria

Anwar Ahmed Hoosen, University of Pretoria

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uropathogens;antimicrobial;South Africa;susceptibility;epidemiology

Cite this article

South African Medical Journal 2009;99(8):584.

Article History

Date submitted: 2008-09-25
Date published: 2009-08-06

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