Antibiotic Resistance Profiling of Uropathogens Isolated from Urinary Tract Infections in Females at a Tertiary Care Hospital in Peshawar

Abstract

Background: Urinary tract infections (UTIs) are among the most frequent bacterial infections affecting women and represent a major cause of outpatient visits and hospital admissions. The increasing emergence of multidrug-resistant uropathogens has complicated empirical treatment, particularly in developing countries where antibiotic misuse is common. Objective: To determine the distribution of uropathogens and assess antimicrobial resistance patterns among women presenting with urinary tract infection at a tertiary care hospital in Peshawar. Methodology: A cross-sectional observational study was conducted at the Department of Pathology, Khyber Teaching Hospital, Peshawar, from 27^th May 2025 to 27^th Oct 2025. Midstream urine samples from 300 symptomatic female patients aged 20–80 years were cultured. Isolates were identified using standard microbiological techniques, and antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method in accordance with CLSI 2025 guidelines. Results: Out of 300 urine samples, 85 (28.3%) yielded significant bacterial growth. Escherichia coli was the most frequently isolated organism (64.7%), followed by Citrobacter species (7.0%) and Enterobacter species (5.8%). Overall, high resistance was observed against ampicillin (82.4%), ciprofloxacin (58.8%), and co-trimoxazole (52.9%). Among E. coli isolates, ampicillin resistance was particularly high (90.9%). Nitrofurantoin and fosfomycin demonstrated comparatively low resistance rates. Multidrug resistance was predominantly observed among E. coli isolates. Conclusion: A high prevalence of multidrug-resistant E. coli limits the effectiveness of commonly used antibiotics in this region. Nitrofurantoin and fosfomycin remain reliable options for empirical therapy in uncomplicated UTIs.