Antimicrobial resistance patterns in UTIs in male patients with associated kidney stone disease: a descriptive study

Urinary tract infections (UTIs) and the widespread use of antibiotics are a growing concern in both the urological field and public health. UTIs affect both male and female patients similarly, with a higher incidence among individuals with excessive rates of stone formation. This study aimed to evaluate the main microorganisms and antimicrobial agents involved in urinary tract infections in men undergoing surgical procedures for urolithiasis over a 2-year period. We conducted a retrospective, single-center, observational study over 24 months, from January 2024 to December 2025. Criteria for inclusion consisted of male patients of at least 18 years old, at least one positive urine culture (>105 CFU/ml), a single bacterial agent, imaging-confirmed urolithiasis, and a history of surgical management of renal stone disease (FURS, URS, and/or PCNL). Cases that were conservatively managed or presented no evidence of urolithiasis, as well as female patients, were excluded from this study. A total of 543 patients underwent assessment. Differences were observed between the incidence of Gram-positive (155, 28.55%) and Gram-negative (388, 71.45%) microbial agents. The highest incidence was highlighted for Escherichia coli (32.33% of cases), followed by Enterococcus spp. (20.81%) and Klebsiella spp. (20.81%). Among the resistance rates for the main antibiotics evaluated, the highest values were observed for Levofloxacin (44.53% for Gram-negative and 55.47% for Gram-positive). This study underscores the importance of appropriate and optimized antimicrobial management, especially in patients undergoing surgery for renal stone disease, reinforcing current data.