Clinical and Microbiological Profile of Multidrug-Resistant Urinary Tract Infections in Tertiary Care Hospitals of Punjab

Abstract

BACKGROUND: Urinary tract infections are among the most common bacterial infections encountered in clinical practice. The increasing emergence of multidrug-resistant uropathogens has complicated management, particularly in tertiary care settings where patients often present with recurrent infections, comorbidities, and prior antibiotic exposure. Local data describing both clinical features and resistance patterns remain essential for guiding effective antimicrobial stewardship.

OBJECTIVE: To describe the clinical characteristics and microbiological profile of multidrug-resistant urinary tract infections in tertiary care hospitals of Punjab, Pakistan.

METHODOLOGY: A descriptive observational study was conducted across three tertiary care hospitals in Punjab from March to October 2022. Adult patients with culture-confirmed multidrug-resistant urinary tract infections were included. Clinical data were recorded using a structured proforma, while urine samples underwent standard culture, identification, and antimicrobial susceptibility testing according to established laboratory guidelines. Data were analyzed using appropriate descriptive and inferential statistical tests, with significance set at p < 0.05.

RESULTS: A total of 385 patients were analyzed, with a mean age of 46.8 ± 15.2 years; 60.3% were female. Prior antibiotic use was documented in 69.4% of cases, and 44.4% had diabetes mellitus. Escherichia coli was the most frequently isolated organism (52.2%), followed by Klebsiella pneumoniae (24.9%) and Pseudomonas aeruginosa (12.2%). High resistance rates were observed for cephalosporins (78.4%) and fluoroquinolones (74.5%), while lower resistance was noted for carbapenems (15.8%) and nitrofurantoin (22.3%).

CONCLUSION: Multidrug-resistant urinary tract infections are common in tertiary care hospitals of Punjab and are associated with significant resistance to first-line antibiotics. These findings emphasize the need for routine culture-based diagnosis and locally informed antimicrobial stewardship strategies.

KEY TERMS: Antimicrobial Resistance; Carbapenems; Multidrug Resistance; Pakistan; Tertiary Care Hospitals; Urinary Tract Infections; Uropathogens