Issues‎ > ‎Vol4n1‎ > ‎



Karwan Raoof Hassan *, Ismaeel Hama Ameen ** and Zhian Salah Ramzi ***

*   Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.
**  Department of Surgery, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.
*** Department of Family and Community Medicine, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.

Submitted: 2/5/2013; Accepted: 5/9/2013; Published 1/6/2014



Urinary tract infection (UTI) is amongst the most common bacterial infections that prompt patients to seek medical advice. Approximately 10% of human populations get urinary tract infection at some stage of their live.


The study was carried out to determine the types of micro-organisms causing UTI and their sensitivity to antibiotics in Sulaimani Teaching Hospital.


Records of patients admitted in Sulaimani Teaching Hospital, who had complicated UTI, were studied for a period of five years, from 1st December 2006 to 1st December 2010. All study subjects who had positive records of urine sample cultures inoculated on MacConkey and blood agar media were included in the study. The isolated bacteria were identified using biochemical tests. Disk diffusion susceptibility test was used to determine susceptibility of bacterial agents to antibiotics.


A total of 2055 urine samples were found to be positive. The main isolated organism was Escherichia coli (E coli) 67.69%, followed by Pseudomonus aeruginosa 11.24%, then Proteus Species 7.15%, Gram negative bacilli 4.53%, Staphylococcus aureus 4.23%, Klebsiella species 3.55% and lastly Salmonella species represented 1.61%.


The commonest microorganism for UTI in this study was E. coli, followed by Pseudomonas, Proteus. Resistance of organisms to antibiotics is high probably due to misuse and overuse of antibiotics.


UTI, Sulaimani, Urine culture and sensitivity.


1- Jarvis WR, Martone WJ. Pediatric urinary tract infections. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992; 29: 19-24.

2- Ronald AR, Nicolle LE, Stamm E, Krieger J, Warren J, Schaeffer A, et al. Urinary tract infection in adults: research priorities and strategies. International Journal of Antimicrobial Agents 2001: 17: 4: 343-348. 

3- Jha N, Bapat SK. A study of sensitivity and resistance of pathogenic micro-organisms causing UTI in Kathmandu valley. Kathmandu University Medical Journal 2005; 3 (2): 123-129.

4- Kunin CM. Detection, prevention and management of urinary tract infections. 4th ed. Philadelphia, PA: Lea and Febiger, 1987. p. 447

5-Williams DH, Schaeffer AJ. Current concepts in urinary tract infections. Minerva Urol Nefrol 2004; 56: 15-31.

6- Jones RN, Thornsberry C. Cefotaxime: a review of in vitro antimicrobial properties and spectrum of activity. Rev Infect Dis 1982; 4: S300-15.

7- Manges AR, Johnson JR, Foxman B, O'Bryan TT, Fullerton KE, Riley LW. Widespread distribution of urinary tract infections caused by a multidrug-resistant Escherichia coli clonal group. N Engl J Med 2001; 345: 1007-1013.

8- Gruneberg GN. Antibiotic sensitivities of urinary pathogens: 1971-1982. J Antimicrob Chemothr 1984; 14: 17-23.

9- Mandell GL, Bennett JE, Dolin R. Principles and practice of infectious diseases. Churchill Livingstone 2005; 881-882.

10-Forbes BA, Sahm DF, weissfeld AS. Bailey and Scott's diagnostic microbiology, 12th ed., Mosby Elsevier, 2007; 842-855.

11-MacFaddin JF. Biochemical tests for identification of medical bacteria. 3rd ed. Philadelphia: Lippincott Williams and wilkins, 2000.

12-Clinical and laboratory Standards Institute. performance standards for antimicrobial susceptibility testing. 12th informational supplement. CLSI document M100-S12. Pennsylvania, USA. 2002; (1): 1.

13- Cheesbrough M. Medical Laboratory Manual for Tropical Countries. Volume II: Microbiology. Cambridge: Cambridge University Press; 1984. p. 146-205.

14-De Francesco MA, Ravizzola G, Peroni L.Urinary tract infections in Brescia, Italy: etiology of uropathogens and antimicrobial resistance of common uropathogens. Med Sci Monit 2007; 13(6): BRI 36-44.

15- Pobiega M, Wojkowska-Mach J, Chmielarczyk A, Romaniszyn D, Adamski P, Heczko PB. Molecular characteristics and drug resistance of Escherichia coli strains isolated from urine from long-term care facility residents in Cracow, Poland. Med Sci monit 2013; 19: 317-326.

16- Bachur R. Noresponders: Prolonged fever among infants with urinary tract infections. Pediatrics 2000; 105: e 59.[pubMed: 10799623].

17- Oreskovi NM, Sembrano EU. Repeat urin cultures in children who are admitted  with urinary tract infections. Pediatr 2007; 119:325-329.

18- Ejrnaes K. Bacterial characteristics of importance for recurrent urinary tract infections caused by Escherichia coli. Dan Med Bull 2011; 58(4): B4187. 

19- Chakupurakal R, Ahmed M, Sobithadevi DN, Chinnappan S, Reynolds T. Urinary tract pathogens and resistance pattern.  J Clin Pathol 2010; 64(7): 652-654. 

20-Hummers-Pradier E, Koch M, Ohse AM, Heizmann WR, Kochen MM. Antibiotic resistance pathogens in female general practice patients. Scand J Infect Dis 2005; 37(4): 256-261.

21-Sakran W, Miron D, Halevy R, Colodner R, Smolkin V, Koren A. Community acquired urinary tract infection among hospitalized children in northern Israel: pathogens, susceptibility patterns and urinary tract anomalies. Harefuah 2003; 142(4): 249-252. 

22-Nurullaev RB. The role of asymptomatic bacteriuria in epidemiologic study of the urinary tract infection (UTI). Lik Aprava 2004; 7: 23-25.

23- JO Olaitan. Asymptomatic bacteriuria in female population of a Nigerian University. Internet J Microbiol 2006; 2: 2-6.

24- Orrett FA, Davis GK. A comparison of antimicrobial susceptibility profile of urinary tract pathogens for the year, 1999 and 2003. west Indian J 2006; 55(2): 95-99.

25- Mava Y, Bello M, Ambe JP, Zailani SB. Antimicrobial sensitivity pattern of organisms causing urinary tract infection in children with sickle cell anemia in Maiduguri, Nigeria. Nigerian Journal of Clinical Pracice 2012; 15(4): 420-423.