# Regional Burden of Urinary Tract Infection, Its Aetiologies, and Antibiotic Resistance Patterns, 2020–2023: A Retrospective Study

## TL;DR

This study examines the causes and antibiotic resistance of urinary tract infections in Ghana's Ashanti Region from 2020 to 2023, highlighting the rise of drug-resistant bacteria.

## Contribution

The study provides recent regional data on UTI pathogens and their resistance patterns, emphasizing the growing threat of multidrug-resistant strains.

## Key findings

- Escherichia coli was the most common UTI pathogen (47.8%), with high resistance to Nalidixic acid and Ofloxacin.
- Klebsiella pneumoniae showed significant resistance to Cefotaxime, Ciprofloxacin, and Trimethoprim/Sulfamethoxazole.
- Multidrug-resistant gram-negative isolates, including ESBL-producing strains, are a major concern for UTI treatment.

## Abstract

The emergence of antibiotic‐resistant strains of urinary tract infections (UTI) pathogens poses a significant challenge to the effective treatment of this condition. This study aimed to conduct a retrospective study to analyze the etiology and antibiotic resistance patterns of common urinary tract pathogens in the Ashanti Region of Ghana.

The study employed a standardized data collection form to extract information on age, sex, urine culture results, antibiotic susceptibility test results, and antibiotic treatment regimens from 2020 to 2023.

The primary agent responsible for UTIs was Escherichia coli, identified in 47.8% of cases, followed by Klebsiella pneumoniae at 15.8%, Staphylococcus aureus at 9.2%, and Pseudomonas aeruginosa at 6.5%. Candida species were detected in 12% of cases, while coagulase‐negative Staphylococci constituted 3.8%. Proteus and Providencia species were observed in 1.1% and 0.5%, respectively. E. coli exhibited complete resistance (100%) to Nalidixic acid (NAL) and Ofloxacin (OFL), with varying degrees of resistance observed across other antibiotics. Among the 29 isolates of K. pneumoniae, 90.0% showed resistance against Cefotaxime, 81.3% against Ciprofloxacin, and 80% against Trimethoprim/Sulfamethoxazole. Sixty percent of E. coli isolates and 25% of Klebsiella isolates demonstrated multi‐drug resistance and ESBL production.

The surge in multidrug‐resistant (MDR) gram‐negative isolates presents a significant healthcare hurdle for UTI patients. A noteworthy portion of prevalent pathogens, resistant to NAL and OFL, falls into the category of ESBL‐producing Enterobacterales and Pseudomonas spp. The limited availability of effective treatments for MDR gram‐negative isolates underscores the urgent need for innovative therapeutic alternatives.