Bacteriological Profile and Antimicrobial Susceptibility Patterns of Urinary Tract Infections in a Tertiary Care Hospital of Multan, Southern Punjab, Pakistan

Abstract

Background: Urinary tract infections (UTIs) represent one of the most common bacterial infections encountered in both community and hospital settings. The increasing emergence of antimicrobial resistance among uropathogens has complicated empirical treatment strategies, particularly in developing regions where surveillance data remain limited. Local antimicrobial susceptibility patterns are essential for guiding rational antibiotic therapy and limiting resistance progression. Objective: To identify the prevalent bacterial pathogens and determine their antimicrobial susceptibility patterns among patients with urinary tract infections in a tertiary care hospital in Multan, southern Punjab, Pakistan. Methods: This cross-sectional study was conducted over four months and included 72 adult patients with culture-confirmed urinary tract infections. Midstream urine samples were processed using standard microbiological techniques. Bacterial identification was performed through Gram staining and biochemical profiling. Antimicrobial susceptibility testing was carried out using the Kirby–Bauer disk diffusion method in accordance with Clinical and Laboratory Standards Institute guidelines. Data were analyzed using SPSS version 26. Continuous variables were expressed as mean ± standard deviation, and categorical variables as frequencies and percentages. Chi-square and independent t-tests were applied where appropriate, with p<0.05 considered statistically significant. Results: The mean age of participants was 36.8 ± 14.2 years, with females comprising 65.3% of cases. Gram-negative organisms accounted for 86.1% of isolates, with Escherichia coli being the most common pathogen (54.2%), followed by Klebsiella pneumoniae (18.1%). High resistance rates were observed against ampicillin (76.4%) and ciprofloxacin (58.3%). Nitrofurantoin (81.9% sensitivity) and imipenem (94.4% sensitivity) demonstrated the highest effectiveness. Multidrug resistance was significantly more frequent among hospitalized patients (p=0.032). Conclusion: Gram-negative bacteria, particularly Escherichia coli, predominated in urinary tract infections, with considerable resistance to commonly used oral antibiotics. Continuous surveillance and strengthened antimicrobial stewardship are essential to guide empirical therapy and curb antimicrobial resistance.