Abstract Background Urinary tract infections (UTIs) are among the leading causes of bacterial infections, affecting millions of people annually and impacting public health. These infections can affect any part of the urinary system, ranging from mild cases to complications like pyelonephritis and sepsis. Several factors can influence the development and severity of UTIs, including age, sex, and comorbidities such as diabetes mellitus. This study aims to analyze the epidemiological profile of UTIs in outpatients from a Brazilian population, investigating the distribution of etiological agents and their association with age, sex, diabetes, and bacterial colony counts. The use of big data for laboratory analysis provides a broad approach to understanding the behavior of these infections, their impact on clinical management, and corroboration with the literature. Methods This epidemiological, cross-sectional study analyzed the distribution of etiological agents in urine cultures from outpatients at a private laboratory in the Northeast region of Brazil. Data between January 2022 and February 2025 were extracted from the LIS system. Urinalysis and urine culture results were analyzed using Sysmex® and Vitek - 2 Compat ® equipment, considering bacterial colony counts and self-reported diabetes status. The population was stratified by sex and age. Results The population was mainly female (79%), with a mean age of 55 ± 22 years. Bacterial growth was observed in 22,326 (19.8%) of the urine cultures (N=112,506). The main pathogens identified were Escherichia coli (12%; N=13,259), Klebsiella pneumoniae (3.2%; N=3,652), Proteus mirabilis (0.9%; N=1,035), and Enterococcus faecalis (0.9%; N=1,002). Extended-spectrum beta-lactamase (ESBL)-positive cases accounted for 14% (N=1,450). Among the ESBL-positive cases, five patients had bacterial growth exceeding 1,000,000 CFU/mL (Klebsiella pneumoniae N=4, Proteus mirabilis N=1), with two cases of dual colonization (Klebsiella/E. coli and Proteus/E. coli). Among the patients, 15% (N=16,473) self-reported as diabetic. This group had a higher prevalence of ESBL-positive infections (18%, N=384), and in cases with more than one isolated microorganism, ESBL positivity was observed in 38%. Candida glabrata was more prevalent in diabetic patients. Conclusion The analysis revealed that most cases occurred in women, particularly those aged 18 to 50 years, with Escherichia coli as the most frequent pathogen. Diabetic patients had a higher prevalence of infections caused by ESBL-positive microorganisms, especially in mixed infections. Additionally, Candida glabrata was more prevalent in this group. The findings show that the prevalence of main UTI pathogens remains similar to that reported in recent years. This study emphasizes the importance of regularly updating epidemiological data to improve clinical management strategies for these infections.
Bezerra et al. (Wed,) studied this question.