Cross-Sectional Investigation of Pathogenic Bacteria Associated with Urinary Tract Infections in Women in AL-Najaf City, Iraq

Background: Urinary tract infections (UTIs) are the most frequent bacterial infection in women and an important public health issue because of their recurrent nature and rising antimicrobial resistance. This research was conducted to find the bacterial causes of UTI in women, and to determine the resistance pattern including MDR, XDR and ESBL production. Methods: One hundred and forty urine samples were obtained from women with confirmed UTIs. Bacterial isolation and identification of the bacterial isolates was carried out as per standard microbiological procedures including Gram staining followed by biochemical characterization. Susceptibilities to antibiotics were tested by the disk diffusion method. Patterns of resistance were categorized as XDR, MDR, or non-MDR, and ESBL production in Gram negative isolates was detected phenotypically. Results: A total of 157 bacterial isolates were recovered from a population of 140 urine samples: the presence of Gram-positive bacteria was observed more frequently than Gram-negative ones. Most of the isolates were related to chronic UTIs, predominantly among women aged 21-30 years and more commonly in married and pregnant women. The predominant pathogens were Enterococcus faecalis and Staphylococcus aureus. The rates of resistance to commonly used antibiotics were also very high with 61.2% and 28% isolates being classified as MDR and XDR respectively. Ciprofloxacin and imipenem were most potent antimicrobial agents among the tested. Conclusion: This study demonstrates the prevalence of chronic UTIs with a shift toward Gram-positive uropathogens and high prevalence of antimicrobial resistance, justifying regular susceptibility testing in addition to rational use of antibiotics.