Introduction: Urinary tract infections (UTIs) represent a growing concern in both clinical practice and public health, affecting hospitalized and outpatient populations across all ages and genders. This study aims to evaluate the prevalence of uropathogens and their antimicrobial resistance profiles in male and female patients comparatively at a tertiary urological center. Materials and Methods: A retrospective descriptive analysis was conducted, covering three identical 6-month periods—September 1 to February 28—in three consecutive years from 2023 to 2025. The study included 2270 male patients (2270. 57.06%) and 1708 female patients (1708. 42.94%), all with at least one positive urine culture (>105 CFU/mL). Data on age, gender, bacterial species, and antimicrobial agents were collected and analyzed. Results: A higher prevalence of Gram-negative bacteria was observed compared to Gram-positive bacteria in both male (1752; 77.18% vs. 518; 22.82%) and female (1369; 80.15% vs. 339; 19.85%) groups. The most common microorganisms were Escherichia coli, followed by Klebsiella and Enterococcus. Klebsiella showed high rates of antimicrobial resistance, especially in males, across various antibiotic classes such as amoxicillin-clavulanic acid (60.6% vs. 43.25%), levofloxacin (40.18% vs. 27.91%), aztreonam (37.4% vs. 27.27%), and ceftazidime (36.23% vs. 24.03%). High resistance levels, although not statistically significant, were also noted for trimethoprim/sulfamethoxazole (43.64%) and nitrofurantoin (65.69%). In males, E. coli exhibited higher resistance rates to trimethoprim/sulfamethoxazole (44.65% vs. 32.89%), levofloxacin (43.27% vs. 30.78%), and amoxicillin-clavulanic acid (40.18% vs. 27.19%). Carbapenems remained highly susceptible in both groups. Enterococcus showed similar resistance patterns in both cohorts, primarily resistant to penicillin and levofloxacin. Conclusion: This study highlights higher resistance rates among Gram-negative bacteria in males to commonly used antibiotics such as fluoroquinolones, trimethoprim/sulfamethoxazole, and β-lactams. Resistance patterns in Gram-positive bacteria remained stable across both populations, with high susceptibility to fosfomycin, nitrofurantoin, linezolid, and carbapenems. Differences between sexes emphasize the need for more detailed analysis of local and sex-specific resistance patterns.
Popescu et al. (Sat,) studied this question.