Patterns of Antimicrobial Resistance in Urinary Tract Infection Pathogens: A Descriptive Study from a Paraguayan Hospital

Introduction: Community-acquired urinary tract infections (UTIs) are a major public health concern due to their high prevalence and increasing antimicrobial resistance. This study aimed to describe the antimicrobial resistance patterns of uropathogens isolated from community-acquired UTIs in a Paraguayan hospital. Methods: A descriptive cross-sectional study was conducted from 2021 to 2023, including 136 patients with confirmed UTIs. Sociodemographic, clinical, and risk factor data were collected. Urine cultures were processed following standard microbiological techniques, and antimicrobial susceptibility testing was performed using the Kirby–Bauer method. Results: Escherichia coli (55.1%) and Klebsiella pneumoniae (19.1%) were the predominant isolates. The most common symptoms were fever (73.5%) and dysuria (63.2%). Among E. coli isolates, high resistance rates were observed to norfloxacin (68.7%) and trimethoprim-sulfamethoxazole (61.5%), while high sensitivity was found to fosfomycin (100%) and nitrofurantoin (95.4%). Extended-spectrum β-lactamase (ESBL) production was detected in 89% of resistant E. coli isolates. K. pneumoniae exhibited resistance to norfloxacin (86%) and ampicillin/sulbactam (75%). Conclusions: E. coli remains the leading uropathogen in community-acquired UTIs, showing high resistance to first-line antibiotics. Continuous local surveillance of antimicrobial susceptibility is essential to guide empirical therapy and reduce the spread of multidrug-resistant organisms.