Abstract
Background: Urinary tract infections are among the most common bacterial infections worldwide, and rising antimicrobial resistance among uropathogens increasingly compromises empirical therapy.
Aim and Objectives: To determine the prevalence of uropathogens and evaluate their antimicrobial susceptibility patterns among patients with urinary tract infections attending a tertiary care teaching hospital over a three-year period.
Methods: This retrospective study reviewed laboratory records of urine samples received in the Department of Microbiology of a tertiary care teaching hospital in North India between January 2021 and December 2023. Specimens were cultured on cystine lactose electrolyte-deficient agar, isolates were identified by standard microbiological methods, and antimicrobial susceptibility testing was performed by the Kirby–Bauer disk diffusion method and interpreted according to Clinical and Laboratory Standards Institute guidelines.
Results: Of 801 urine samples processed, 298 (37.2%) yielded significant microbial growth. Females accounted for 62.4% of culture-positive cases, with infection most frequent in the 21–30-year age group (25.2%). Escherichia coli was the predominant uropathogen (39.3%), followed by Enterococcus spp. (28.9%), coagulase-negative staphylococci (9.1%), and Klebsiella spp. (7.0%); Gram-negative bacilli predominated overall (55.4% of bacterial isolates). Fosfomycin (96%) and nitrofurantoin (78%) were the most active oral agents against E. coli, whereas fluoroquinolone susceptibility was poor (ciprofloxacin 21%; levofloxacin 27%). Linezolid, vancomycin, and teicoplanin retained excellent activity (93–100%) against Gram-positive isolates, including all MRSA isolates. Klebsiella spp. showed maximum susceptibility to cotrimoxazole (84%), and carbapenem susceptibility among non-fermenters was suboptimal.
Conclusions: Escherichia coli remained the predominant uropathogen, with higher prevalence among females. Sustained local surveillance, culture-guided therapy, and antimicrobial stewardship are essential to preserve the effectiveness of the remaining oral agents.
Keywords: Urinary tract infection; Uropathogens; Escherichia coli; Antimicrobial susceptibility; Antibiotic resistance; Retrospective study