Profile of antimicrobial resistance of uropathogens in urinary tract infections: An analysis of 1117 hospitalized patients in Brazil

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• Escherichia coli was the most frequently uropathogen, mainly in women with UTI. • Gram-negative bacteria showed high resistance to beta-lactams and quinolones. • Higher BMI was significantly associated with antimicrobial resistance. • Patients with resistance had a higher risk of 30-day recurrence and elevated urea levels. • Recurrent UTIs were mainly community-acquired, with relevant clinical impact. : Urinary tract infections (UTIs) are among the most common infections worldwide, with Escherichia coli (E. coli) being the predominant pathogen, particularly in women. The rise of antimicrobial resistance, especially due to extended-spectrum β-lactamase (ESBL)-producing E. coli, has significantly limited treatment options, posing a serious public health concern. Rational antibiotic use and continuous monitoring of resistance patterns are essential to address this challenge. : To evaluate the antimicrobial resistance profile of uropathogens isolated from patients diagnosed with UTI. : This was an observational, longitudinal, and analytical study conducted between April 2024 and January 2025, including 1,171 patients diagnosed with UTI at a private hospital in São Paulo, Brazil. Data were extracted from medical records and included demographics, comorbidities, antibiotic use, and laboratory results. Statistical analysis was performed using SPSS software, applying Student's t-test and chi-square test, with p<0.05 considered statistically significant. : The study population consisted of 894 women and 223 men, with a mean age of 41.9 ± 14.15 years. Gram-negative bacteria were predominant, with E. coli being the most frequently isolated pathogen. High resistance rates were observed against commonly used antibiotics, particularly beta-lactams and quinolones. A significant association was found between higher BMI and antimicrobial resistance, as well as elevated serum urea levels in resistant cases. : The findings highlight a pattern of antimicrobial resistance in ICU pathogens. These results highlight the need for antimicrobial stewardship, surveillance programs, and individualized therapeutic strategies based on local resistance profiles.

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