Incidence of Symptomatic Urinary Tract Infection and Antimicrobial Resistance Profiles of Isolated Uropathogens In Several Regions of Punjab, Pakistan: A Comprehensive Review

Ayesha Fazal; Hammad Qaiser; Tehrim Zafar; Ali Hasan; , Zeeshan Asghar; Urooj Liaqat; Abrar Hussain

doi:10.69885/pju.v4i1.128

Authors

Ayesha Fazal Department of Biological Sciences, COMSATS university, Islamabad, Pakistan https://orcid.org/0009-0007-7237-8650
Hammad Qaiser Department of Biological Sciences, International Islamic University, Islamabad, Pakistan https://orcid.org/0009-0004-3794-3288
Tehrim Zafar Department of Urology University of Sialkot, Sialkot, Pakistan https://orcid.org/0009-0001-3359-8884
Ali Hasan Department of Microbiology, University of Faisalabad, Faisalabad, Pakistan https://orcid.org/0000-0002-3410-3978
, Zeeshan Asghar Department of Urology University of Sialkot, Sialkot, Pakistan https://orcid.org/0000-0003-2429-2055
Urooj Liaqat Department of Urology University of Sialkot, Sialkot, Pakistan https://orcid.org/0009-0008-5012-151X
Abrar Hussain Department of Biological Sciences, International Islamic University, Islamabad, Pakistan https://orcid.org/0000-0003-2948-921X

DOI:

https://doi.org/10.69885/pju.v4i1.128

Keywords:

Antimicrobial susceptibility, Antibiotic resistant, Urinary Tract Infections

Abstract

ABSTRACT

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide and are increasingly complicated by antimicrobial resistance (AMR). Limited region-specific data in Pakistan hinder effective empiric therapy. To determine the prevalence, uropathogen distribution, and antimicrobial susceptibility patterns of bacterial isolates from urine cultures in the Sialkot and Rawalpindi/Islamabad regions of Pakistan. A cross-sectional analysis of 605 urine specimens was performed: 120 from Sialkot and 485 from Rawalpindi/Islamabad. Culture and susceptibility data were extracted from laboratory records, standardized, and harmonized. Organism identification followed routine microbiological protocols. Antimicrobial susceptibility testing was performed according to CLSI guidelines and recorded as susceptible, intermediate, or resistant. Overall, 142/605 (23.5%) cultures were positive, with significantly higher positivity in Sialkot (51.7%) than Rawalpindi/Islamabad (16.5%, p<0.001). Gram-negative bacteria predominated (81.2%), with Escherichia coli as the most frequent isolate (42.9%), followed by Klebsiella pneumoniae and Serratia spp. E. coli exhibited high resistance to Ampicillin, Ceftriaxone, and Fluoroquinolones, while retaining high susceptibility to Nitrofurantoin, Fosfomycin, Aminoglycosides, and Carbapenems. Gram-positive isolates remained universally susceptible to Vancomycin and Linezolid. E. coli is the dominant Gram-negative uropathogen in both regions, with alarming resistance to commonly prescribed antibiotics. Empiric therapy should prioritize nitrofurantoin and Fosfomycin for uncomplicated UTIs, while stewardship-guided use of aminoglycosides or carbapenems is recommended for complicated cases.

Keywords: Antimicrobial susceptibility, Antibiotic resistant, Urinary Tract Infections