Background: Urinary tract infection (UTI) is one of the most common bacterial infections, with significant implications for antimicrobial resistance (AMR) management. Empiric treatment relies on current knowledge of local uropathogen prevalence and antimicrobial resistance pattern, which vary by region and over time. This study aimed to determine the distribution of bacterial pathogens causing UTIs and their antimicrobial resistance pattern over a five-year period (2019–2023) at a tertiary care hospital in coastal Karnataka. The findings are intended to support updates to the hospital’s antibiotic policy and aid in the effective management of UTI cases. Methods: A retrospective analysis was conducted on 1279 urine culture isolates processed between January 2019 and December 2023. Uropathogens were identified using standard microbiological techniques, and antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Year-wise resistance trends were analyzed statistically. Results: Gram-negative bacilli were the predominant uropathogens, with Escherichia coli being the most frequent isolate, followed by Klebsiella pneumoniae. Other Gram-negative and Gram-positive isolates included Citrobacter koseri, Proteus mirabilis, Pseudomonas spp., Acinetobacter spp., Morganella morganii, Enterococcus spp., MSSA, and MRSA. Resistance to cephalosporins, piperacillin-tazobactam, and carbapenems showed an increasing trend over the five years. However, a significant reduction in resistance to oral antibiotics such as cotrimoxazole and nitrofurantoin was observed in 2023 compared to prior years. Conclusion: The persistence of Gram-negative bacilli, particularly E. coli, as predominant uropathogens highlights their clinical significance. The observed decline in resistance to certain oral antibiotics offers a potential opportunity for their empiric use in uncomplicated UTIs. Continuous surveillance and antibiotic stewardship are essential to mitigate further escalation of antimicrobial resistance. Keywords: urinary tract infection; antimicrobial resistance; uropathogens; trend analysis; empiric therapy; cotrimoxazole; nitrofurantoin
Kinila et al. (Wed,) studied this question.