Drug Resistance Patterns and Pathogen Distribution in Patients with Urinary Tract Infection in Suzhou, China: A Five-Year Retrospective Study (2020–2024)
Abstract
Objective To investigate the distribution of pathogens and their antimicrobial resistance profiles in urine cultures from patients with urinary tract infections (UTIs) in Suzhou, China, and to guide empirical treatment decisions. Methods We analyzed 9,249 non-duplicate, positive midstream urine cultures collected from January 2020 to December 2024. Bacterial and fungal identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility testing (AST) was conducted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Results Female patients (60.1%) and those aged >65 years (64.3%) accounted for the majority of cases. Escherichia coli (33.3%) was the predominant pathogen followed by Enterococcus faecalis (8.6%), Klebsiella pneumoniae (8.4%), and Enterococcus faecium (8.0%). Its resistance to third/fourth-generation cephalosporins (eg, cefotaxime from 50.4% to 38.8%) decreased significantly (P 60%). Carbapenem resistance in Klebsiella pneumoniae exhibited alarming fluctuations, peaking at 40.6% in 2023. The prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli decreased significantly. Enterococcus faecium displayed extreme resistance to ampicillin and fluoroquinolones (>94%), whereas Enterococcus faecalis was more susceptible. Azole resistance in Candida albicans markedly declined but remained high in Candida tropicalis. Conclusion Escherichia coli…
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