Exploring Antibiotic Resistance Patterns in Escherichia coli Isolates from Urinary Tract Infections: A Retrospective Study

<b>Objectives</b>: This retrospective analysis was conducted to update the antibiotic sensitivity profiles of <i>Escherichia coli (E. coli)</i> in urinary tract infections (UTIs) among adults (≥18 years) in Jordan. <b>Methods</b>: Data were collected from patients diagnosed with UTIs and confirmed by positive <i>E. coli</i> cultures between 1 January 2019 and 9 July 2021. The resistance patterns of <i>E. coli</i> to empiric antibiotics were assessed by matching the prescribed antibiotics with those tested, using clinical breakpoints to classify isolates as susceptible or resistant. <b>Results</b>: During the study, 230 patients with urine cultures confirming <i>E. coli</i> infection were included. Empiric antibiotics were prescribed to 87.4% (n = 201) of patients. Sensitivity testing was performed for 136 patients (59.1%), revealing that 62 patients (27%) had <i>E. coli</i> strains resistant to at least one antibiotic. Among the 236 empiric antibiotics prescribed, the appropriateness of 72 agents (30.5%) could not be determined owing to the absence of sensitivity testing. The culture results indicate that eight antibiotics (3.3%) did not provide adequate coverage against <i>E. coli</i>. Of the remaining 156 agents (66.1%) subjected to sensitivity testing, 89 (37.7%) were effective, while 67 (28.3%) were ineffective owing to bacterial resistance. Patients who underwent sensitivity tests performed had significantly longer hospital stays (10 days) than those who did not (8 days; <i>p</i> = 0.032). Female patients had a higher proportion of resistant <i>E. coli</i> isolates (51.5%) compared to males (30.8%, <i>p</i> = 0.036). <b>Conclusions</b>: This study highlights the importance of ongoing surveillance to guide empiric therapy and promote appropriate antibiotic use. Tailoring treatment based on patient-specific factors is essential to effectively managing antimicrobial resistance and improving clinical outcomes.