Assessment of aminoglycosides and β-lactam resistance genes among uropathogens; a prospective-cross sectional study.

Urinary tract infections (UTIs) represent a major public health challenge worldwide, accounting for millions of outpatient consultations and substantial healthcare expenditure annually. In this prospective cross-sectional investigation conducted from February 2019 to January 2020 at a tertiary-care hospital in Islamabad, Pakistan, we examined the etiological agents of UTI, their antimicrobial susceptibility profiles, and the occurrence of the aminoglycoside resistance genes aac(6’)-Ib-cr and the β-lactam resistance genes blaTEM among 503 patients with suspected UTI. Culture-confirmed UTI was established in 127 patients (25.2%; 95% CI 21.5–29.3%), with markedly higher prevalence in females (33.6%) than males (16.8%; P < 0.001). Of these, 16 (12.6%) yielded polymicrobial growth. Gram-negative bacilli predominated (110/127 isolates, 86.6%), led by Escherichia coli (91/127, 71.7%), followed by Klebsiella spp. (9/127, 7.1%), Proteus spp. (6/127, 4.7%), and Pseudomonas spp. (4/127, 3.1%). Among Gram-negative isolates, susceptibility was highest to cefepime (75.8%) and cefoxitin (68.1%), whereas resistance exceeded 65% against gentamicin, ampicillin, ceftriaxone, and ciprofloxacin, with 68.1% classified as multidrug-resistant. Gram-positive isolates retained full susceptibility to imipenem and vancomycin. These findings underscore the urgent requirement for routine culture-guided therapy, enhanced antimicrobial stewardship, and continuous local surveillance to mitigate the emergence of untreatable uropathogens.