Evolving trends in uropathogens and antimicrobial resistance: Five-year data from a tertiary care hospital

Kinila S, Furtado ZV, Rai YK, Mahale K, Bhat G

Pdf Page Numbers :- 233-238

Shreevidya Kinila^1,*, Zevita Venisha Furtado¹, Yashvanth Kumar Rai¹, Kanchan Mahale¹ and Gopalakrishna Bhat¹

¹Department of Microbiology, Kanachur Institute of Medical Sciences, Mangaluru, Karnataka 575 018, India

*Corresponding author: Dr. Shreevidya Kinila, M.D. Microbiology, Department of Microbiology, Kanachur Institute of Medical Sciences, Mangaluru, Karnataka 575 018, India. Email: drshreevidya5@gmail.com

Received 13 February 2025; Revised 26 May 2025; Accepted 9 June 2025; Published 18 June 2025

Citation: Kinila S, Furtado ZV, Rai YK, Mahale K, Bhat G. Evolving trends in uropathogens and antimicrobial resistance: Five-year data from a tertiary care hospital. J Med Sci Res. 2025; 13(3):233-238. DOI: http://dx.doi.org/10.17727/JMSR.2025/13-41

Copyright: © 2025 Kinila S et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

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