Background: Urinary tract infections (UTIs) are among the most frequently encountered bacterial infections in clinical practice. They contribute substantially to outpatient visits, hospital admissions, and antimicrobial use worldwide. Tertiary care hospitals, in particular, manage patients with complicated UTIs who often have underlying comorbidities, prolonged hospital stays, or prior antibiotic exposure, which can influence the spectrum of uropathogens. Continuous surveillance of local uropathogen profiles is therefore essential to guide appropriate empirical therapy and strengthen antimicrobial stewardship programs. The present study was undertaken to determine the spectrum and prevalence of bacterial pathogens isolated from urine specimens in a tertiary care hospital and to analyze their distribution with respect to inpatient and outpatient status as well as gender. Material and Methods: This was a descriptive cross-sectional study conducted in the Department of Microbiology at a tertiary care teaching hospital over a period of three months. A total of 110 urine samples were collected from patients clinically suspected of having UTIs, attending both inpatient (IPD) and outpatient (OPD) services, irrespective of age and gender. Midstream urine samples were collected aseptically in sterile containers, while catheterized samples were obtained from the catheter sampling port. Samples were processed within two hours of collection. Microscopic examination of uncentrifuged urine was performed, followed by culture on CLED agar, MacConkey agar, blood agar, and nutrient agar using a calibrated loop. Significant bacteriuria was defined as a colony count of 10⁵ CFUmL. Isolates were identified based on colony morphology, Gram staining, and standard biochemical tests. Data were analyzed using descriptive statistics and expressed as frequencies and percentages. Results: Out of 110 urine specimens, all yielded significant bacterial growth. Escherichia coli was the most predominant uropathogen, accounting for 45 isolates (41). This was followed by coagulase-negative staphylococci (CONS) with 23 isolates (21) and Klebsiella spp. with 19 isolates (17). Other organisms isolated included Enterococcus spp. (9), Pseudomonas spp. (6), Acinetobacter spp. (3), Staphylococcus spp. (2), and Proteus vulgaris (1). Overall, both IPD and OPD settings, Gram-negative organisms were more frequently isolated than Gram-positive cocci, with a higher isolation rate observed among inpatients. Conclusion: The study demonstrates that UTIs in a tertiary care hospital are predominantly caused by Gram-negative bacteria, with Escherichia coli remaining the leading uropathogen. The higher prevalence of infections among inpatients highlights the influence of hospitalization-related risk factors. Regular monitoring of local uropathogen distribution is essential to support effective empirical treatment and improve patient outcomes.
Jain et al. (Sun,) studied this question.