"Uropathogens and antimicrobial susceptibility patterns in urosepsis patients at kafr el sheikh University hospital: a cross-sectional study".

Urosepsis is a life-threatening consequence of urinary tract infections, often linked to obstruction, indwelling devices, and healthcare exposure. Increasing antimicrobial resistance among uropathogens complicates empirical therapy and adversely affects outcomes, making local surveillance essential for appropriate management. To determine the bacterial profile and antimicrobial susceptibility patterns of urosepsis cases admitted to Kafr El-Sheikh University Hospital. This cross-sectional study included 168 patients with confirmed urosepsis admitted to the Urology Unit between February 2024 and October 2025. Urosepsis was defined by identical organisms in urine and blood cultures with systemic sepsis and a SOFA score of ≥ 2. Cultures were processed using standard microbiological methods, with identification confirmed by biochemical testing and ATR-FTIR. Antimicrobial susceptibility testing was performed using the Kirby-Bauer method according to CLSI 2024 and verified by the BD Phoenix™ system. Multidrug-resistant (MDR) and ESBL-producing organisms were identified using standard criteria. The mean age of the patients was 56.2 ± 15.6 years, and 70.8% were male. Catheter-associated infections were identified in all cases (100%), reflecting the healthcare-associated nature of this cohort, while renal abscesses were detected in 26.2%. Gram-negative organisms predominated (90.5%), with Escherichia coli being the most frequently isolated pathogen. Statistical analysis revealed no significant demographic or clinical predictors of antimicrobial resistance patterns (p > 0.05). Gram-negative isolates showed higher susceptibility to carbapenems and fluoroquinolones. ESBL-producing isolates accounted for 24.34% and were susceptible to carbapenems. MDR isolates comprised 27.63% and showed high resistance to cephalosporins, piperacillin-tazobactam, and carbapenems. All gram-positive isolates were fully sensitive to vancomycin and teicoplanin. Catheter-associated urosepsis is mainly caused by resistant gram-negative pathogens. The high prevalence of ESBL and MDR strains underscores the need for early culture-guided therapy and continuous local antimicrobial surveillance to optimize outcomes.