Fluoroquinolone-Resistant Urinary Tract Infections: A One-Year Retrospective Study

Introduction: Urinary tract infections (UTIs) are among the most common bacterial infections encountered in clinical practice. The emergence of fluoroquinolone resistance poses a significant challenge to their management, given their frequent use as first-line therapy. Objectives: This retrospective study evaluates the prevalence, risk factors, and antimicrobial susceptibility patterns of fluoroquinolone-resistant uropathogens isolated from patients at G.B. Pant Hospital, Delhi, over one year (January 2023 to December 2023). Methods: Urine samples collected from inpatients and outpatients with clinically suspected UTIs were processed by standard microbiological techniques. Antimicrobial susceptibility testing was performed following CLSI guidelines 2023. Results: Among 1,243 uropathogens with significant growth, 872 isolates (70.2, 95 CI: 67.6-72.7) were resistant to fluoroquinolones. The most common pathogen showing fluoroquinolone-resistance was Escherichia coli (76.1, 95 CI: 73.1-78.9). Prior antibiotic use (adjusted OR: 1.70, 95 CI: 1.24-2.33, p0.001), diabetes mellitus (adjusted OR: 1.38, 95 CI: 1.03-1.86, p0.032) and recurrent UTIs (adjusted OR: 1.95, 95 CI: 1.43-2.66, pConclusion: Alternative agents including fosfomycin (91.4 susceptibility), nitrofurantoin (85.6), and carbapenems (92.3) demonstrated good activity against fluoroquinolone-resistant isolates. Our findings highlight the growing resistance trends, providing insights into epidemiological and microbiological data to inform empiric therapy and antimicrobial stewardship policies.