Background: Urinary tract infections (UTI) are very common in all the population around the world. Women are the usual victims of the super bug Escherichia coli (E.coli) and usually suffer from UTI once in a lifetime. The multi-drug resistant (MDR) E.coli is very intelligent creature and turned resistant to the antibiotics through transposons, mutations and plasmids. Most of the E.coli harbors the gene bla-NDM-1 due to which they have become highly resistant to Carbapenem antibiotics.

Objectives: To find the bla-NDM-1 gene in Carbapenem resistant E.coli isolated from UTI patients. To determine the frequency of Carbapenem resistant E.coli in patients attending tertiary care hospital of Peshawar.

Methodology: This study was conducted in Khyber Teaching Hospital Peshawar from January 2019 to June 2019. we collected 87 urinary E.coli isolates which were resistant to Carbapenem by disc diffusion method on Mueller Hinton Agar. Polymerase chain reaction (PCR) was done to unyield the presence of bla-NDM-1 gene in these 87 cases.

Results: According to this study E.coli was the most common causative agent for UTI and females suffered more than male patients. The antibiotics Tigecycline and Colistin showed 100% sensitivity against E.coli. Some of the antibiotics like Ampicillin; Meropnem etc were 100% resistant to E.coli. The gene bla-NDM-1 turned out to be positive in 26.43% of the cases.

Conclusion: This study concluded that all the E.coli isolated from UTI patients having bla-NDM-1 gene exhibit resistance to Carbapenem. These isolates are very difficult to treat and limited therapeutic options are available.

Keywords: Multi- drug resistant Escherichia coli, Carbapenemases, Antibiogram, Plasmids, Polymerase chain reaction, Transposons and Mutations.