Bacteriological Spectrum and Antimicrobial Susceptibility of Urinary Tract Infections in Inpatients and Outpatients at Public and Private Hospitals in Erbil City: Bacteriological Spectrum and Antimicrobial Susceptibility of Urinary Tract Infections

Kamgar Akram Rasul; Shler Ghafour Raheem

doi:10.63841/iue3261091

Authors

Kamgar Akram Rasul Department of Physiology, Microbiology and Genetics, College of Medicine, Hawler Medical University, Kurdistan Region, IRAQ Author https://orcid.org/0009-0001-9961-2618
Shler Ghafour Raheem Department of Physiology, Microbiology and Genetics, College of Medicine, Hawler Medical University, Kurdistan Region, IRAQ Author https://orcid.org/0009-0001-8213-7371

DOI:

https://doi.org/10.63841/iue3261091

Keywords:

Urinary Tract Infection, Gram Negative Bacilli, Escherichia coli, Antibiotic-Resistant.

Abstract

Urinary tract infection is a prevalent bacterial infection affecting individuals of all ages, with Escherichia coli being the most common causative agent. Rising antimicrobial resistance poses a major challenge to empirical treatment, particularly in resource-limited settings. This study aimed to identify the most frequently isolated bacteria in urine samples from Erbil city and evaluate their antimicrobial susceptibility.

A cross-sectional study was conducted from September 2024 to March 2025, involving 501 patients clinically suspected of urinary tract infection. Midstream urine samples were collected and analyzed through general urine examination, culture, and antibiotic sensitivity testing using the Vitek-2 system. Sociodemographic and clinical data were collected through structured questionnaires.

Of 501 participants, 401 (80%) had positive urine cultures, with a significant female predominance (75.8%). Adults (18–64 years) constituted the majority (74.8%). Escherichia coli was the most frequently isolated pathogen (193 cases, 48.1%), followed by Klebsiella pneumoniae and Pseudomonas aeruginosa (32). Gram-negative bacteria accounted for 81.8% of all isolates. High resistance was observed to commonly used antibiotics, including ciprofloxacin, cephalosporins, and trimethoprim/sulfamethoxazole. Nitrofurantoin and amikacin showed the highest sensitivity against most isolates, especially Escherichia coli. Fluoroquinolone resistance was notably high among Escherichia coli and K. pneumoniae.

This study highlights the significant clinical multidrug-resistant Gram-negative pathogens in UTIs, with Escherichia coli as the primary cause. Nitrofurantoin and Amikacin remain effective options, while ciprofloxacin and several cephalosporins show decreasing efficacy.

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Bacteriological Spectrum and Antimicrobial Susceptibility of Urinary Tract Infections in Inpatients and Outpatients at Public and Private Hospitals in Erbil City