Uropathogenic Bacteria and Antimicrobial Resistance Patterns in Community-Acquired UTIs: Evidence from a Regional Study in Bangladesh

Abstract

Background: Urinary tract infections (UTIs) remain one of the most common bacterial infections, and their effective management is increasingly challenged by rising antimicrobial resistance (AMR), particularly in low- and middle-income countries where routine surveillance is limited. Local data on uropathogen distribution and resistance patterns are essential to guide empirical therapy.

Objective: This study aimed to identify the bacterial etiology of community-acquired UTIs and to assess antimicrobial susceptibility patterns among patients attending a diagnostic laboratory in Pabna Sadar, Bangladesh.

Methodology: A one year and six-month retrospective laboratory-based study was conducted, analyzing 80 consecutive, non-duplicate bacterial isolates recovered from clinically significant urine samples. Bacterial identification was performed using standard microbiological techniques, including colony morphology, Gram staining, and biochemical tests. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines, using 16 commonly prescribed antibiotics. Data were analyzed using descriptive statistics and chi-square tests where applicable.

Results: Of the 80 participants, 64 (80.0%) were female and 16 (20.0%) were male, with a significant difference in gender distribution (χ² = 28.8, df = 1, p < 0.001). The mean age was 35.5 ± 21.5 years. Acinetobacter spp. (30%) and Escherichia coli (30%) were the most frequently isolated uropathogens, followed by Enterobacter spp. (17.5%), Klebsiella spp. (8.8%), Staphylococcus spp. (7.5%), and Pseudomonas spp. (6.3%). Overall susceptibility was highest to amikacin (67.5%), gentamicin (60.0%), and nitrofurantoin (60.0%). Susceptibility to levofloxacin and ciprofloxacin was 51.2% and 48.8%, respectively. The lowest susceptibility was observed for amoxicillin (10.0%), ceftazidime (21.2%), and cefotaxime (25.0%). Marked species-specific differences in susceptibility were also observed, with Pseudomonas spp. showing complete susceptibility to gentamicin but complete resistance to ceftriaxone and cefotaxime.

Conclusion: The study demonstrates a high burden of antimicrobial resistance among uropathogens causing community-acquired UTIs in this regional setting. The findings highlight the need for regular local AMR surveillance and rational antibiotic prescribing to support effective empirical treatment and antimicrobial stewardship.

Bangladesh Journal of Infectious Diseases, June 2026;13(1):293-299