Urinary tract infections among medical sciences students in Dhamar City, Yemen: prevalence, risk factors, and antimicrobial susceptibility patterns

Urinary Tract Infections (UTIs) are the most common bacterial infection in humans and a major cause of morbidity and mortality. UTIs affect individuals across all age groups and both genders, with associated complications contributing substantially to the global disease burden. This study aimed to estimate the prevalence and risk factors of urinary tract infections and antimicrobial susceptibility among Al-Hikma University medical sciences students in Dhamar City, Yemen. A cross sectional descriptive study was conducted from December 2021 to August 2022, included 336 students (211 males; 125 females). The median age of participants was 21 years (range: 17–38 years). Mid-stream urine (MSU) specimens were aseptically collected for UTI microscopic examination and, culture to identify the etiological agents followed by evaluation of antimicrobial susceptibility pattern using Kirby Bauer disc diffusion method. Data were collected using a pretested structured questionnaire. Data were analyzed using SPSS programm, version 20.0. The overall prevalence of bacterial UTIs was 11.6% (39/336). Escherichia coli was the predominant uropathogen (66.7%, 26/39), followed by Staphylococcus saprophyticus (17.9%, 7/39), Klebsiella pneumoniae (10.3%, 4/39), Proteus spp. (2.6%, 1/39), and Enterococcus faecalis (2.6%, 1/39). The highest UTI prevalence was observed among fifth-year students (23.53%), with borderline statistical significance (P = 0.054). Significant risk factors associated with UTIs included insufficient family monthly income (OR = 4.20, 95% CI: 1.26–14.03; P = 0.012), overcrowded living conditions (> 3 persons per sleeping room) (OR = 2.70, 95% CI: 1.31–5.55; P = 0.009), and the presence of other medical problems (OR = 2.93, 95% CI: 1.49–5.78; P = 0.001). The most common clinical symptoms among infected students were dysuria (33.33%) and cloudy urine (33.33%). Antimicrobial susceptibility testing revealed that all isolates (100%) were susceptible to gentamicin, while 79.49% were susceptible to levofloxacin and amikacin. High resistance rates were observed against ampicillin (51.28%), ciprofloxacin (51.28%), and doxycycline (46.15%). This study reveals a relatively low prevalence of UTIs among medical sciences students, with E. coli as the predominant pathogen. The findings highlight significant associations with socioeconomic factors and overcrowding, while the high resistance rates to commonly used antibiotics, particularly cefixime and ciprofloxacin, underscore the urgent need for antimicrobial stewardship programs and evidence-based treatment guidelines in this population.