Antimicrobial resistance was studied in Escherichia coli strains isolated from urine samples of 457 patients suffering from urinary tract infection. High prevalence of class 1 integrons (43.56%), sulfamethoxazole resistance genes sul1 (45.54%) and sul2 (51.48%) along with occurrence of quinolone resistance genes was detected in multi drug resistance isolates.

Escherichia coli is considered to be the main causative agent of urinary tract infections (UTIs). The primary objective of this study was to investigate the spectrum of five virulence factors among drug-resistant clinical E. coli isolates associated with pyelonephritis and cystitis. A total of 101 samples were positive for E. coli (42 from pyelonephritis cases and 59 from cystitis cases) out of 457 urine samples of patients. Among toxins, haemolysin and secreted autotransporter toxin are found more frequently in isolates causing pyelonephritis (p < 0.020) than cystitis (p < 0.083). The frequent occurrence of P-pili, S-fimbria and protein involved in intestinal colonisation was noted among E. coli isolates associated with pyelonephritis. Overall, the study suggests that clinical isolates associated with pyelonephritis are more virulent than those associated with cystitis and diversified association with various antimicrobial resistance phenotypes was noted.

Objective: To determine the in-vitro antimicrobial susceptibility pattern of Methicillin-resistant Staphylococcus aureus (MRSA) isolates using an automated VITEK-2 compact system. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Railway Hospital (PRH) Rawalpindi collaborates with the Armed Forces Institute of Pathology (AFIP) Rawalpindi, from Sep 2018 to Aug 2019. Methodology: 100 MRSA samples were isolated from tissue, pus, urine, blood, high vaginal swabs (HVS) and ear swabs using standard microbiological techniques. MRSA isolates' antimicrobial susceptibility pattern was made using an automated VITEK-2 compact system. Results: Among 100 MRSA isolates, 63% were obtained from pus and 17% from tissue, respectively. MRSA isolates showed 100% sensitivity to Vancomycin, Teicoplanin and Linezolid. Susceptibility to other drugs has shown wide variation, i.e., Tigecycline 97%, Rifampicin 95%, Clindamycin 86%, Tetracycline 79%, and Cotrimoxazole 78%. The minimum inhibitory concentration (MICs) of Vancomycin and Linezolid against MRSA isolates revealed that 41% had 0.5 µg/ml, 46% had one µg/ml, and 13% had two µg/ml for Vancomycin. Whereas for Linezolid, 38 isolates had MIC 1 µg/ml, then 62 isolates had MIC 2 µg/ml. Conclusion: All the isolates showed 100% sensitivity to Vancomycin, Teicoplanin and Linezolid. Moreover, being less costly, Clindamycin, Tetracycline and Cotrimoxazole are good oral choices for empirical therapy against minor MRSA infections.