Epidemiological insights and antimicrobial susceptibility of urinary tract infections: Evidence from a large cohort study

Urinary tract infections (UTIs) are among the most common bacterial infections, with increasing antimicrobial resistance posing a major public health concern. The evaluation of antimicrobial sensitivity patterns has a significant role in prescribing antimicrobial drugs to treat patients suffering from urinary tract infections (UTIs). This study aimed to investigate the prevalence, microbial profile and antibiotic susceptibility patterns of uropathogens in both outpatient and inpatient settings. A total of 4200 suspected UTI cases were enrolled between July 2023 and July 2024. Urine cultures were collected and subjected to culture, biochemical and sensitivity testing. Prior antibiotic history and co-infection patterns were also analyzed. Of the total cases, 21.8% were culture positive. Females constituted 69.8% of the cases, with the highest prevalence in the 21-40 years age group; among children, UTIs were most common in ages 1-5 years. A total of 917 microorganisms were isolated, with Escherichia coli (65%) and Klebsiella pneumoniae (14%) being predominant. Antibiotic susceptibility testing showed high sensitivity to Imipenem (94.9%), Meropenem (94.1%), Amikacin (88.4%), Netilmicin (89.2%), Chloramphenicol (87.8%) and Nitrofurantoin (86.9%), whereas high resistance was observed against Ampicillin (74.2%), Azithromycin (65.5%) and several cephalosporins. Prior antibiotic exposure was associated with reduced culture positivity (17.4%) and co-infections were detected in 4.9% of cases, mainly in inpatients. UTIs were predominantly caused by E. coli and K. pneumoniae with carbapenems, aminoglycosides and Nitrofurantoin showing the highest efficacy. High resistance rates to commonly used antibiotics highlight the need for continuous surveillance, rational antibiotic use and strict infection control measures.