Antibiotic Resistance Patterns in Urinary Tract Infections: A Two-Year Retrospective Study
DOI:
https://doi.org/10.62497/irjcs.160Keywords:
Urinary tract infections, UTI, antibiotic resistance, E. coli, hospital-acquired UTI, community-acquired UTI, antimicrobial susceptibilityAbstract
Introduction: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, affecting all age groups and both sexes. Increasing antibiotic resistance among uropathogens poses a significant challenge to effective management and increases the risk of treatment failure.
Objective: To determine the antibiotic resistance patterns of uropathogens in culture-positive UTIs and assess associations with patient demographics and type of infection.
Methodology: This two-year retrospective study was conducted at the Department of Microbiology, Abbottabad international medical college (AIMC), Abbottabad, from January 2022 to December 2023. A total of 220 culture-positive UTI cases were included. Patient demographics, type of UTI (community- or hospital-acquired), and uropathogen distribution were recorded. Antibiotic susceptibility was analyzed using standard laboratory methods. Descriptive statistics and Chi-square tests were performed to assess associations between demographics, type of infection, and resistance patterns.
Results: Among 220 cases, the mean age was 37.4 ± 18.6 years, with females comprising 58.2% of the cohort. Escherichia coli was the most frequent uropathogen (55%), followed by Klebsiella pneumoniae (19.1%) and Enterococcus spp. (11.8%). Overall antibiotic resistance was 42.7% with the highest resistance observed against amoxicillin-clavulanate and ceftriaxone. Nitrofurantoin and meropenem retained the highest efficacy. Hospital-acquired UTIs were significantly associated with higher resistance rates (p < 0.05). No significant associations were found with age or gender. Temporal trends showed a slight, non-significant increase in resistance over the two-year period.
Conclusion: Antibiotic resistance among UTI pathogens is high, particularly in hospital-acquired infections. Nitrofurantoin and meropenem remain effective treatment options. Continuous local surveillance, rational antibiotic prescribing, and implementation of stewardship programs are essential to reduce the burden of multidrug-resistant UTIs.
References
Mancuso G, Midiri A, Gerace E, Marra M, Zummo S, Biondo C. Urinary tract infections: the current scenario and future prospects. Pathogens. 2023 Apr 20;12(4):623.https://doi.org/10.3390/pathogens12040623
Ghali H, Saad OK, Bhiri S, Balhi S, Azouzi F, Maatouk A, Boughattas S, Layouni S, Anoun J, Benzarti S, Trabelsi E. Epidemiology and risk factors of healthcare-associated urinary tract infections: a prospective study in a Tunisian tertiary hospital. Scientific Reports. 2025 Aug 15;15(1):29948.https://doi.org/10.1038/s41598-025-03971-z
Ibrahim AI, Abdelgyoum HA, Elfaki NS, Elbadawi MH, Kashif E. Bacterial etiology of urinary tract infections and their sensitivity patterns towards commonly used antibiotics in port Sudan City, Sudan: a retrospective study. BMC Infectious Diseases. 2025 Aug 13;25(1):1017.https://doi.org/10.1186/s12879-025-11437-w
Niccodem EM, Majigo M, Nyongole OV, Manyahi J, Shangali A, Mwingwa AG, Kunambi PP, Lyamuya E. Urinary tract infections and associated factors among patients with an enlarged prostate at a tertiary hospital, Dar es Salaam, Tanzania: a hospital-based cross-sectional study. BMJ open. 2024 Oct 1;14(10):e085580.https://doi.org/10.1136/bmjopen-2024-085580
ElFeky DS, Kassem AA, Moustafa MA, Assiri H, El-Mahdy AM. Suppression of virulence factors of uropathogenic Escherichia coli by Trans-resveratrol and design of nanoemulgel. BMC microbiology. 2024 Oct 17;24(1):412.https://doi.org/10.1186/s12866-024-03538-4
Al Lawati H, Blair BM, Larnard J. Urinary tract infections: core curriculum 2024. American Journal of Kidney Diseases. 2024 Jan 1;83(1):90-100.https://doi.org/10.1053/j.ajkd.2023.08.009
Al Qahtani M, Naghib ME, Alshamrani AM, Al Mazroua AM, Alayyaf AS, Ofisan SB, Kamal SM. The incidence, clinical features and outcome of urinary tract infections in geriatric patients: A prospective longitudinal study. IJID regions. 2024 Dec 1;13:100469.https://doi.org/10.1016/j.ijregi.2024.100469
Mareș C, Petca RC, Popescu RI, Petca A, Mulțescu R, Bulai CA, Ene CV, Geavlete PA, Geavlete BF, Jinga V. Update on urinary tract infection antibiotic resistance—a retrospective study in females in conjunction with clinical data. Life. 2024 Jan 9;14(1):106.https://doi.org/10.3390/life14010106
Asamoah B, Labi AK, Gupte HA, Davtyan H, Peprah GM, Adu-Gyan F, Nair D, Muradyan K, Jessani NS, Sekyere-Nyantakyi P. High resistance to antibiotics recommended in standard treatment guidelines in Ghana: a cross-sectional study of antimicrobial resistance patterns in patients with urinary tract infections between 2017–2021. International Journal of Environmental Research and Public Health. 2022 Dec 9;19(24):16556.https://doi.org/10.3390/ijerph192416556
Coppola N, Maraolo AE, Onorato L, Scotto R, Calò F, Atripaldi L, Borrelli A, Corcione A, De Cristofaro MG, Durante-Mangoni E, Filippelli A. Epidemiology, mechanisms of Resistance and Treatment Algorithm for infections due to Carbapenem-Resistant Gram-negative Bacteria: an Expert Panel Opinion. Antibiot (Basel). 2022; 11 (9): 1263. DOI: https://doi. org/10.3390/antibiotics11091263.
Khan A, Saraf VS, Siddiqui F, Batool T, Noreen Z, Javed S, Ahmad A, Alonazi WB, Ibrahim M, Pucciarelli S, Bokhari H. Multidrug resistance among uropathogenic clonal group A E. Coli isolates from Pakistani women with uncomplicated urinary tract infections. BMC microbiology. 2024 Mar 7;24(1):74.https://doi.org/10.1186/s12866-024-03221-8
Zanichelli V, Monnier AA, Gyssens IC, Adriaenssens N, Versporten A, Pulcini C, Le Maréchal M, Tebano G, Vlahović-Palčevski V, Stanić Benić M, Milanič R. Variation in antibiotic use among and within different settings: a systematic review. Journal of Antimicrobial Chemotherapy. 2018 Jun 1;73(suppl_6):vi17-29.https://doi.org/10.1093/jac/dky115
Somani BK. Advancements in urinary tract infections: understanding, prevention, diagnosis, and treatment. Therapeutic Advances in Infectious Disease. 2025 Sep;12:20499361251376457.https://doi.org/10.1177/20499361251376457
Afeke I, Adu-Amankwaah J, Hamid AW, Kwadzokpui PK, Aninagyei E, Emmanuel G, Deku JG. Urinary tract infections and antimicrobial susceptibility: A retrospective trend analysis of uropathogens in women in Accra, Ghana (2019–2022). PloS one. 2025 Apr 4;20(4):e0321293.https://doi.org/10.1371/journal.pone.0321293
Kornfält Isberg H, Sundqvist M, Melander E, Beckman A, Hedin K. Bacterial growth and antimicrobial resistance in urinary Escherichia coli isolates among men with lower UTI in Swedish primary healthcare: retrospective data over a 4 year period. JAC-Antimicrobial Resistance. 2025 Feb;7(1):dlae214.https://doi.org/10.1093/jacamr/dlae214
Moghnia OH, Al Otaibi HS, Al Haqqan AM, Sokhn ES, Pathan SS, Abdulaziz NE, Mohammed HY, Al-Sweih NA. Prevalence of Urinary Tract Infections and Antibiotic Susceptibility Patterns of Uropathogens among Neonates in Maternity Hospital, Kuwait: A Six-Year Retrospective Study. Medical Principles and Practice. 2025 Jun 3;34(3):250-61.https://doi.org/10.1159/000543368
Hussain T, Moqadasi M, Malik S, Zahid AS, Nazary K, Khosa SM, Arshad MM, Joyce J, Khan R, Puvvada S, Walizada K. Uropathogens antimicrobial sensitivity and resistance pattern from outpatients in Balochistan, Pakistan. Cureus. 2021 Aug 28;13(8).DOI: 10.7759/cureus.17527
Bwanali AN, Lubanga AF, Kondowe S, Nzima E, Mwale A, Kamanga W, Enerico C, Masautso C, Kapatsa T, Mudenda S, Mpinganjira S. Trends and patterns of antimicrobial resistance among common pathogens isolated from adult bloodstream and urinary tract infections in public health facilities in Malawi, 2020–2024. BMC Infectious Diseases. 2025 Jul 26;25(1):946.https://doi.org/10.1186/s12879-025-11335-1
Nakandi RM, Kakeeto P, Kihumuro RB, Kanyike AM, Nalunkuma R, Lugwana RS, Kasozi F, Muyanja D, Mayega NR, Mutesasira JK, Mutebi RK. Antibiotic susceptibility patterns of bacterial uropathogens at a private tertiary hospital in Uganda: a retrospective study. BMC Infectious Diseases. 2025 Apr 25;25(1):605.https://doi.org/10.1186/s12879-025-11005-2
Werneburg GT. Catheter-associated urinary tract infections: current challenges and future prospects. Research and reports in urology. 2022 Apr 4:109-33.https://doi.org/10.2147/RRU.S273663
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