Drug Resistance Patterns and Pathogen Distribution in Patients with Urinary Tract Infection in Suzhou, China: A...

Area of Science:

• Microbiology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Urinary tract infections (UTIs) are common, and antimicrobial resistance (AMR) poses a significant challenge to effective treatment.
• Understanding local pathogen distribution and resistance patterns is crucial for guiding empirical therapy decisions.

Purpose of the Study:

• To investigate the distribution of pathogens and their antimicrobial resistance profiles in urine cultures from patients with UTIs in Suzhou, China.
• To provide data to guide empirical treatment decisions for UTIs in the region.

Main Methods:

• Analysis of 9,249 positive midstream urine cultures from January 2020 to December 2024.
• Bacterial and fungal identification using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).
• Antimicrobial susceptibility testing (AST) following Clinical and Laboratory Standards Institute (CLSI) guidelines.

Main Results:

• *Escherichia coli* (33.3%) was the predominant pathogen, followed by *Enterococcus faecalis* (8.6%), *Klebsiella pneumoniae* (8.4%), and *Enterococcus faecium* (8.0%).
• Carbapenem resistance in *Klebsiella pneumoniae* peaked at 40.6% in 2023, while fluoroquinolone resistance remained high (>60%).
• *Enterococcus faecium* showed extreme resistance (>94%) to ampicillin and fluoroquinolones, whereas *Enterococcus faecalis* was more susceptible.

Conclusions:

• *Escherichia coli* is the primary bacterial urinary pathogen in Suzhou.
• High carbapenem resistance in *Klebsiella pneumoniae* and severe resistance in *Enterococcus faecium* limit treatment options.
• Temporal changes necessitate ongoing surveillance, tailored empirical therapy, and robust antimicrobial stewardship programs for effective UTI management.