Uropathogenic profiles and antibiotic resistance in gynecological cases: a microbial surveillance study from Northeast India

Urinary tract infection (UTI) is one of the most common bacterial infections affecting women worldwide. This study investigated bacterial diversity, associated risk factors, and multidrug resistance (MDR) patterns among Gynecological patients in the northeastern region of India. A total of 896 participants were enrolled in the study. Midstream urine specimens were collected and processed using standard microbiological procedures to confirm infection. Antimicrobial susceptibility testing was performed in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines, 2022. Of the 896 participants, 278 (31.02%) were microbiologically confirmed as UTI-positive. Significant associations were observed between UTI prevalence and several risk factors, including age 18–39 years (OR 2.14, p < 0.001), previous history of UTI (OR 7.81, p < 0.001), hypertension (OR 2.75, p < 0.001), prior antibiotic use (OR 2.99, p < 0.001), and pregnancy (OR 1.96, p < 0.001). The most prevalent pathogens were Escherichia coli (62.5%) and Klebsiella pneumoniae (16.9%). Notably, E. coli , K. pneumoniae , Proteus mirabilis , and Pseudomonas aeruginosa demonstrated high resistance to fluoroquinolones, nalidixic acid, ampicillin, and cephalosporins. In contrast, these isolates showed higher susceptibility to fosfomycin, amikacin, gentamicin, ertapenem, and piperacillin/tazobactam. The findings highlight region-specific antimicrobial resistance trends and underscore the need for targeted antibiotic stewardship policies, continuous surveillance, and routine integration of microbiological testing into Gynecological practice to optimize treatment outcomes and curb the spread of resistant pathogens.