Uropathogen Distribution Across Successive Positive Urine Cultures Among Female Patients with Dysglycaemia

Female patients with dysglycaemia may undergo repeated urine cultures, but longitudinal microbiological data from the Gulf are limited. We retrospectively examined successive positive urine cultures from 67 female patients attending a tertiary hospital in Ajman, United Arab Emirates, between May 2016 and September 2025. Organism identity, extended-spectrum beta-lactamase (ESBL) phenotype, HbA1c and culture dates were extracted from laboratory records. Twenty-eight participants (41.8%; 95% CI 30.5-53.7) had a second recorded positive culture and ten (14.9%; 95% CI 7.9-24.9) had a third; the median interval between the first and second cultures was 161 days (IQR 74-402). Escherichia coli was the most frequent organism at each culture. At the index culture, non-ESBL E. coli accounted for 38.8% of specimens, ESBL-producing E. coli for 25.4% and Candida species for 19.4%. Recovery of the same organism or phenotype category between the first and second cultures occurred most often with E. coli (17.9% non-ESBL; 14.3% ESBL-producing). Restricting the analysis to index cultures from 2023 to 2025 did not materially change the organism distribution. Because urinary symptoms and isolate-level susceptibility results were unavailable, positive cultures could not be classified as symptomatic infection, asymptomatic bacteriuria or candiduria, and treatment appropriateness could not be assessed. Prospective studies linking symptoms, susceptibility profiles and clinical outcomes are warranted.