Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania

Background The escalating rates of antibiotic resistance, especially through Extended-Spectrum Beta-Lactamase (ESBL) production within Enterobacterales represents a critical challenge in the effective management and treatment of urinary tract infections (UTIs). This study aims to examine the distribution of pathogens, assess the prevalence of ESBL production, and analyze the resistance patterns of Enterobacterales isolated from outpatient urocultures in Albania. Methods Midstream urine specimens from 406 patients were cultured on MacConkey agar and analyzed using the VITEK 2 automated system (bioMérieux, France). Samples with a bacterial count of ≥ 100,000 CFU/ml were considered positive for UTIs. Statistical analyses were conducted using SPSS software, version 27.0. Results Among the analyzed samples, 271 (66.7%) tested positive for UTIs. Gram-negative bacteria, particularly Enterobacterales (88.5%) were the most common while E. coli was the predominant microorganism (87.0%). The demographic analysis revealed that females (74.5%) and young adults (18-34 years) (54.0%) were the most affected groups. High resistance rates were observed for tetracycline (55.0%), piperacillin (43.0%), and trimethoprim (38.5%), while resistance to meropenem was very low (1.0%). A total of 25 isolates (12.5%) were positive for ESBL production. Among the E. coli isolates, 12.1% (21/174) tested positive. Statistical analysis indicated a significant association between female gender and increased antibiotic resistance. Conclusions Our findings highlight the significant issue of antibiotic resistance in community-acquired UTIs in Albania, particularly involving Enterobacterales. Ongoing surveillance and tailored treatment strategies, alongside antibiotic stewardship programs, are crucial to address this growing public health concern.