Urinary Tract Infection at MZH: Prevalence, Etiologic Organisms, Antimicrobial Susceptibility Patterns, and Predictors of Antibiotic Resistance: A Cross- Sectional Analytical Study

Background: Urinary tract infections (UTIs) are among the most common bacterial infections globally. Rising antimicrobial resistance (AMR) limits the effectiveness of empirical therapy. Local susceptibility data are essential for guiding treatment, particularly in regions with high antibiotic utilization. Methods: A cross-sectional analytical study was conducted at Madinat Zayed Hospital (MZH) from January to December 2024 among adult inpatients with culture-confirmed UTIs. Demographic, clinical, microbiological, and treatment variables were collected.Antimicrobial susceptibility testing followed CLSI 2024 standards using Kirby–Bauer disk diffusion and MIC methods [4]. Resistance was defined at the isolate level as non-susceptibility (resistant or intermediate) to the antibiotic group assigned for that isolate. Binary logistic regression identified independent predictors of resistance. Results: Ninety-eight patients were included (mean age 56.54 ± 22.39 years; 50% male). Escherichia coli was the predominant organism (49.0%), followed by Klebsiella pneumoniae (20.4%) and Pseudomonas aeruginosa (12.2%). Overall, 26 isolates (26.5%) were classified as resistant, 69 (70.4%) as sensitive, and 3 (3.1%) as intermediate. Aminoglycosides demonstrated the highest sensitivity rate (92.0%), while cephalosporins showed the highest resistance rate (40.5%). In multivariable logistic regression, Gram-negative organism type (adjusted odds ratio [AOR] 3.41, 95% CI 1.22–9.56, p = 0.019) and cephalosporin exposure on admission (AOR 2.87, 95% CI 1.03–7.98, p = 0.044) were independently associated with resistance. Model fit was acceptable (Hosmer–Lemeshow p = 0.42); Nagelkerke R² = 0.19 indicated modest explanatory power. Conclusion: UTIs at MZH were predominantly caused by Gram-negative organisms, with notable resistance to cephalosporins and penicillins. Aminoglycosides remained highly effective in vitro. Early cephalosporin exposure and Gram-negative species were independent predictors of resistance. These findings support culture- guided therapy and continued antimicrobial stewardship. Given the modest sample size and limited number of resistance events, the regression results should be interpreted as hypothesis-generating. Keywords: urinary tract infection, antimicrobial resistance, E. coli, susceptibility pattern, logistic regression, Gram-negative bacteria