Comparative Analysis of Clinical Situation, Pathogen Distribution, and Antibiotic Resistance in Urinary Tract Infections Between Outpatients and Inpatients

Urinary tract infections (UTIs) are among the most prevalent bacterial infections in both community and healthcare settings. In this study, we conducted a retrospective analysis of 1,516 urinary tract infection (UTI) patients (1,179 inpatients and 337 outpatients) at the Fourth Affiliated Hospital of Soochow University between January 1, 2021, and December 31, 2024. The study aimed to compare clinical characteristics, pathogen distribution, and antibiotic resistance profiles between outpatient and inpatient UTI cases. Key findings revealed a significantly higher urine culture positivity rate in females compared to males, with this gender disparity being more pronounced among outpatients. The peak age of UTI onset varied between groups: inpatients (both sexes) and male outpatients exhibited the highest incidence in the 70-79-year age group, whereas female outpatients peaked earlier (50-59 years). <i>Escherichia coli</i> (<I>E</I>. coli) remained the predominant pathogen in both cohorts, though its prevalence was higher in outpatients. In contrast, inpatients displayed greater microbial diversity, with a broader spectrum of isolated pathogens. <I>E</I>. coli and <i>Enterococcus</i> isolates from inpatients demonstrated higher overall antibiotic resistance than those from outpatients. These findings underscore distinct epidemiological and resistance patterns between outpatient and inpatient UTI cases, providing critical insights for optimizing empirical antibiotic therapy and reinforcing the need for tailored antimicrobial stewardship strategies in these populations.