Comparative Antibiogram of Escherichia coli Isolated from the Urinary Tract Infection in Patients of Different Age and Sex Groups in Chittagong, Bangladesh

Md. Firoz Alam¹, Maruf Abony¹, Md. Suprio Sadat Sikdar¹, Hasib Adnan¹, Dilruba Akhter¹, Kaniz Fatema¹, Suvamoy Datta^1*

This study showed the critical need for regular antibiotic resistance monitoring and targeted therapies to manage multidrug-resistant E. coli in UTIs effectively.

Abstract

Background: Urinary tract infections (UTIs) are prevalent worldwide, with Escherichia coli (E. coli) responsible for over 85% of cases. Rising antibiotic resistance among UTI pathogens, largely due to antibiotic misuse, complicates treatment and demonstrates the need for regular resistance monitoring. Methods: This study investigated antibiotic resistance in E. coli isolates from 256 UTI patients, analyzing resistance to ten commonly prescribed antibiotics and assessing multidrug resistance (MDR) patterns across demographic groups. Results: E. coli was isolated in 15.63% of samples, showing high resistance to Cefuroxime (92%) and low resistance to Imipenem (5%), indicating Imipenem’s potential as an effective treatment. Overall, 72.5% of E. coli isolates were classified as MDR, with resistance to five or more antibiotics. Notably, young females and elder males exhibited the highest MDR rates (81.81%), suggesting demographic-specific resistance trends. Conclusion: This study showed the critical need for routine antibiograms to guide empirical therapy, as well as for improved antibiotic stewardship to limit resistance spread. Cefuroxime's high resistance rate suggests it may be ineffective in this patient group, whereas Imipenem and Nitrofurantoin may serve as better options. These findings emphasize the importance of targeted antimicrobial strategies and continuous surveillance to manage UTIs effectively in the face of growing antibiotic resistance. Future research should focus on understanding MDR drivers and developing novel treatments to improve UTI outcomes and mitigate the public health impact of resistant infections.

Keywords: Urinary tract infection (UTI), Escherichia coli (E. coli), Antibiotic resistance, Multidrug resistance (MDR), Empirical therapy

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