Antimicrobial Resistance Patterns among Uropathogens Isolated from Positive Urine Cultures: A Cross-Sectional Study

Ibrahim O. Eswaey; Mohamed A. Alghoj; Mohamed Abu Sneana; Hadeel Izeit; Johnny M. Jwely

doi:10.26629/uzjms.2025.09

Authors

Ibrahim O. Eswaey Department of Medical Laboratories, Faculty of Medical Technology, Sabratha University, Libya. https://orcid.org/0009-0003-1991-3264
Mohamed A. Alghoj Department of Diabetes and Endocrinology, Faculty of Medicine, University of Zawia, Libya. https://orcid.org/0009-0001-2928-3820
Mohamed Abu Sneana Department of Biological Sciences/Biomedical Sciences, Libyan Academy for postgraduate,Janzur, Libya and The Multidisciplinary Clinic of Zawia, Libya. https://orcid.org/0009-0005-7934-212X
Hadeel Izeit Department of Genetic, Faculty of Science, University of Misurata, Libya and the Department of Biological Sciences/Biomedical Sciences, Libyan Academy Misrata, Libya. https://orcid.org/0009-0007-5901-3489
Johnny M. Jwely Department of Botany, Faculty of Science, University of Zintan, Libya. https://orcid.org/0009-0009-0799-286X

DOI:

https://doi.org/10.26629/uzjms.2025.09

Keywords:

Urinary tract infection, antimicrobial resistance, ESBL, E. coli, Klebsiella, empirical therapy.

Abstract

Background: Urinary tract infections (UTIs) stand as one of the most frequently encountered bacterial infections worldwide, yet the growing challenge of antimicrobial resistance has made treatment increasingly difficult. This study set out to examine which bacteria are most commonly responsible for UTIs in our region and how susceptible they remain to available antibiotics.

Materials and Methods: We analyzed 150 urine samples that tested positive for bacterial growth, collected between 2022 and 2024 from various private clinics in Zawia, Libya. Standard laboratory techniques were employed to identify the bacteria and test their susceptibility to 13 different antimicrobial agents. We then organized our findings according to bacterial species, patient characteristics, and resistance profiles.

Results: Escherichia coli emerged as the leading culprit, accounting for 58 isolates (38.7%), followed by Klebsiella species (36 isolates, 24.0%), Proteus mirabilis (12 isolates, 8.0%), Staphylococcus aureus (11 isolates, 7.3%), and Pseudomonas species (10 isolates, 6.7%). Women represented nearly three-quarters of cases (72.7%). The highest resistance rates were observed with amoxicillin (88.7%) and ampicillin (85.3%), while carbapenems specifically imipenem showed the lowest resistance at just 4.7%. Notably, 43.3% of E. coli and Klebsiella isolates displayed the extended-spectrum beta-lactamase (ESBL) phenotype, evidenced by their resistance to third-generation cephalosporins. More than 40% of E. coli isolates were resistant to fluoroquinolones.

Conclusions: Our findings reveal troubling levels of antimicrobial resistance, particularly against first-line treatment options, highlighting the pressing need for improved antibiotic stewardship and locally tailored empirical therapy guidelines. Carbapenems and amikacin continue to represent effective choices for severe infections, though their careful use is essential to maintain their effectiveness.