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Urinary Tract Infections Management / Reproductive Tract Infections Research · Journal article
Bangladesh Journal of Infectious Diseases · September 8, 2026
Early or partial results. Treat as a signal, not a conclusion.
This retrospective laboratory surveillance study of 80 uropathogenic isolates from a single Bangladeshi centre documents high prevalence of Acinetobacter spp. and E. coli (each 30%) and substantial antimicrobial resistance, with highest susceptibility to amikacin (67.5%), gentamicin (60.0%), and nitrofurantoin (60.0%), and lowest to amoxicillin (10.0%), ceftazidime (21.2%), and cefotaxime (25.0%). The findings provide local epidemiologic data to guide empirical therapy but lack clinical outcomes and prospective validation.
Retrospective laboratory-based surveillance study. 80 consecutive, non-duplicate bacterial isolates recovered from clinically significant urine samples at a diagnostic laboratory in Pabna Sadar, Bangladesh; study population 80% female, 20% male; mean age 35.5 ± 21.5 years.. Intervention: Antimicrobial susceptibility testing using Kirby-Bauer disk diffusion method with 16 antibiotics per CLSI guidelines. n = 80. Pabna Sadar, Bangladesh.
Acinetobacter spp. and E. coli each represented 30% of isolates; Enterobacter spp. 17.5%, Klebsiella spp. 8.8%, Staphylococcus spp. 7.5%, Pseudomonas spp. 6.3% Highest susceptibility to amikacin 67.5%, gentamicin 60.0%, nitrofurantoin 60.0% Susceptibility to levofloxacin 51.2% and ciprofloxacin 48.8%
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Clinicians in this region may use these local resistance patterns to inform empirical therapy for community-acquired UTIs, reserving aminoglycosides and nitrofurantoin for first-line use and avoiding amoxicillin, third-generation cephalosporins, and fluoroquinolones where resistance is high. However, this single-centre, small-sample study should be complemented by ongoing prospective surveillance and clinical outcome data before firm treatment guidelines are adopted.
Single-centre, retrospective laboratory surveillance of bacterial isolates with descriptive epidemiology and resistance patterns; provides local data to guide therapy but lacks clinical outcomes, prospective enrolment, or comparison groups.
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Clinicians in this region may use these local resistance patterns to inform empirical therapy for community-acquired UTIs, reserving aminoglycosides and nitrofurantoin for first-line use and avoiding amoxicillin, third-generation cephalosporins, and fluoroquinolones where resistance is high. However, this single-centre, small-sample study should be complemented by ongoing prospective surveillance and clinical outcome data before firm treatment guidelines are adopted.
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Background: Urinary tract infections (UTIs) remain one of the most common bacterial infections, and their effective management is increasingly challenged by rising antimicrobial resistance (AMR), particularly in low- and middle-income countries where routine surveillance is limited. Local data on uropathogen distribution and resistance patterns are essential to guide empirical therapy. Objective: This study aimed to identify the bacterial etiology of community-acquired UTIs and to assess antimicrobial susceptibility patterns among patients attending a diagnostic laboratory in Pabna Sadar, Bangladesh. Methodology: A one year and six-month retrospective laboratory-based study was conducted, analyzing 80 consecutive, non-duplicate bacterial isolates recovered from clinically significant urine samples. Bacterial identification was performed using standard microbiological techniques, including colony morphology, Gram staining, and biochemical tests. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines, using 16 commonly prescribed antibiotics. Data were analyzed using descriptive statistics and chi-square tests where applicable. Results: Of the 80 participants, 64 (80.0%) were female and 16 (20.0%) were male, with a significant difference in gender distribution (χ² = 28.8, df = 1, p < 0.001). The mean age was 35.5 ± 21.5 years. Acinetobacter spp. (30%) and Escherichia coli (30%) were the most frequently isolated uropathogens, followed by Enterobacter spp. (17.5%), Klebsiella spp. (8.8%), Staphylococcus spp. (7.5%), and Pseudomonas spp. (6.3%). Overall susceptibility was highest to amikacin (67.5%), gentamicin (60.0%), and nitrofurantoin (60.0%). Susceptibility to levofloxacin and ciprofloxacin was 51.2% and 48.8%, respectively. The lowest susceptibility was observed for amoxicillin (10.0%), ceftazidime (21.2%), and cefotaxime (25.0%). Marked species-specific differences in susceptibility were also observed, with Pseudomonas spp. showing complete susceptibility to gentamicin but complete resistance to ceftriaxone and cefotaxime. Conclusion: The study demonstrates a high burden of antimicrobial resistance among uropathogens causing community-acquired UTIs in this regional setting. The findings highlight the need for regular local AMR surveillance and rational antibiotic prescribing to support effective empirical treatment and antimicrobial stewardship. Bangladesh Journal of Infectious Diseases, June 2026;13(1):293-299
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