Antibiotic Sensitivity and Resistance Patterns of Uropathogens in Peshawar, Pakistan

Background: Urinary tract infections (UTIs) are a major global health issue, primarily caused by bacteria invading the urinary system. Escherichia coli is the most common pathogen, with increasing resistance to antibiotics posing treatment challenges. Objective: This study evaluated the antibiotic sensitivity and resistance patterns of uropathogens from UTI patients in Peshawar, Pakistan, to guide effective therapy and inform local healthcare practices. Methods: A cross-sectional study was conducted from January 1 to May 30, 2023, at the Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar. The study included patients aged 16 years and older diagnosed with UTIs. Urine samples were cultured, and significant bacteriuria was defined as growth of ≥10<sup>5</sup> CFU/mL. Uropathogens were tested for antibiotic sensitivity using the disk diffusion method and VITEK-2 compact system. Data were analyzed using IBM SPSS version 25. Results: Of 137 samples, 80.3% were gram-negative, and 19.7% were gram-positive. Escherichia coli was the most prevalent pathogen (57.7%). Among gram-negative bacteria, Fosfomycin had 91.2% sensitivity, while Cefixime showed 85.5% resistance. For gram-positive bacteria, Piperacillin/Tazobactam had 100% sensitivity, while Cefixime and Moxifloxacin had 100% resistance. Conclusion: The study identified Escherichia coli as the predominant uropathogen, with significant resistance to common antibiotics like Ciprofloxacin and Cefixime. Fosfomycin, Meropenem, and Imipenem were more effective against resistant strains. Routine susceptibility testing and updated treatment protocols are essential to combat antibiotic resistance and improve patient outcomes.