Epidemiology, Patterns of Antimicrobial Resistance, and Profiles of Multidrug Resistance in Uropathogens Associated with Clinically Confirmed Urinary Tract Infections: A Retrospective Study from a Resource-Limited Setting
Description
The study encompassed all patients diagnosed with clinically confirmed urinary tract infections (UTIs) whose urine samples were submitted to and analyzed by the IBB Laboratory during the specified period. Clinical confirmation of UTI was determined by the presence of typical symptoms (such as dysuria, frequency, urgency) along with positive urine culture results yielding ≥10^5 colony-forming units per milliliter (CFU/mL) of a single uropathogen, in accordance with established diagnostic guidelines. Patients with asymptomatic bacteriuria, contaminated samples (mixed flora), or duplicate isolates from the same infection episode were excluded. Consecutive sampling was utilized to reduce selection bias, resulting in a total of 216 eligible cases.
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Essential demographic, clinical, and laboratory information was collected from the laboratory information system and associated patient medical records by trained research staff using a standardized data collection template. Data accuracy and completeness were confirmed through double-entry and cross-validation processes. Urine cultures were carried out following standard microbiological protocols. Samples were inoculated onto cystine lactose electrolyte-deficient (CLED) agar and blood agar plates and incubated aerobically at 35–37°C for 18–24 hours. Bacterial identification at the species level was accomplished using a combination of conventional biochemical tests and automated systems (e.g., VITEK 2, bioMérieux), supplemented by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry when available. Antimicrobial susceptibility testing (AST) was performed using the Kirby-Bauer disk diffusion method and/or broth microdilution per Clinical and Laboratory Standards Institute (CLSI) guidelines (2023 edition). The antibiotic panel comprised agents typically employed in UTI treatment. Quality control strains (e.g., Escherichia coli ATCC 25922) were simultaneously tested to verify assay validity.
Institutions
- Ibb UniversityIbb