Exploring Antibiotic Resistance Patterns in Escherichia coli Isolates from Urinary Tract Infections: A Retrospective...

Objectives: This retrospective analysis was conducted to update the antibiotic sensitivity profiles of Escherichia coli (E. coli) in urinary tract infections (UTIs) among adults (≥18 years) in Jordan. Methods: Data were collected from patients diagnosed with UTIs and confirmed by positive E. coli cultures between 1 January 2019 and 9 July 2021. The resistance patterns of E. coli to empiric antibiotics were assessed by matching the prescribed antibiotics with those tested, using clinical breakpoints to classify isolates as susceptible or resistant. Results: During the study, 230 patients with urine cultures confirming E. coli infection were included. Empiric antibiotics were prescribed to 87.4% (n = 201) of patients. Sensitivity testing was performed for 136 patients (59.1%), revealing that 62 patients (27%) had E. coli strains resistant to at least one antibiotic. Among the 236 empiric antibiotics prescribed, the appropriateness of 72 agents (30.5%) could not be determined owing to the absence of sensitivity testing. The culture results indicate that eight antibiotics (3.3%) did not provide adequate coverage against E. coli. Of the remaining 156 agents (66.1%) subjected to sensitivity testing, 89 (37.7%) were effective, while 67 (28.3%) were ineffective owing to bacterial resistance. Patients who underwent sensitivity tests performed had significantly longer hospital stays (10 days) than those who did not (8 days; p = 0.032). Female patients had a higher proportion of resistant E. coli isolates (51.5%) compared to males (30.8%, p = 0.036). Conclusions: This study highlights the importance of ongoing surveillance to guide empiric therapy and promote appropriate antibiotic use. Tailoring treatment based on patient-specific factors is essential to effectively managing antimicrobial resistance and improving clinical outcomes.