Bacteriological Profile and Antimicrobial Resistance Pattern of Community-Acquired Urinary Tract Infections Among Adult Outpatients in a Tertiary Care Hospital
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Background: Community-acquired urinary tract infections are frequently treated empirically, but increasing antimicrobial resistance may reduce the effectiveness of commonly prescribed agents. Local organism-specific surveillance is therefore required. Objective: To determine the bacterial profile, antimicrobial susceptibility patterns and prevalence of multidrug resistance among adult outpatients with suspected community-acquired urinary tract infection. Methods: This cross-sectional laboratory-based study analysed 300 midstream urine specimens from symptomatic adult outpatients attending a tertiary-care hospital in Multan, Pakistan. Bacterial isolates were identified using conventional microbiological methods, and antimicrobial susceptibility was assessed using Kirby–Bauer disk diffusion according to Clinical and Laboratory Standards Institute criteria. Results were summarised using frequencies, percentages and 95% confidence intervals. Results: Significant bacterial growth was detected in 184 specimens (61.3%; 95% CI: 55.7–66.7%). Escherichia coli was the predominant isolate (58.7%), followed by Klebsiella pneumoniae (13.0%), Enterococcus species (9.8%) and Pseudomonas aeruginosa (6.5%). E. coli susceptibility was 82.4% to nitrofurantoin, 79.6% to fosfomycin and 93.5% to meropenem, but only 41.7% to ciprofloxacin and 38.9% to trimethoprim-sulfamethoxazole. Overall, 71 isolates (38.6%; 95% CI: 31.9–45.8%) were multidrug-resistant. MDR was detected in 36.1% of E. coli and 50.0% of K. pneumoniae isolates. Conclusion: E. coli was the principal uropathogen, and substantial resistance was observed to several commonly prescribed agents. Organism-specific local antibiograms and culture-guided prescribing are required to support appropriate outpatient treatment
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