Bacterial uropathogens, associated factors, and ESBL-producing gram-negative isolates in diabetic patients at Debre Markos comprehensive specialized hospital, Ethiopia.

This study assessed the prevalence of bacterial uropathogens, antibiotic resistance, associated factors, and extended-spectrum β-lactamases ( ESBL)-producing Enterobacteriaceae uropathogens in diabetes mellitus (DM) patients at Debre Markos Comprehensive Specialized Hospital, Ethiopia. A cross-sectional study was conducted from April to July 2023 among 189 DM patients. Urine samples were processed using standard urine culture techniques. Bacterial identification was performed based on colony morphology on culture media, Gram staining, microscopic examination, and biochemical tests. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method, and ESBL production was confirmed by the combination disc method according to CLSI guidelines for Enterobacteriaceae. Significant bacteriuria was found in 17.5% (33/189), higher in females (27.6%) than males (8.8%). Identified risk factors included female sex, age 25–34, prior UTI, and recent hospitalization. Escherichia coli (45.5%) was the predominant isolate. Multidrug resistance (MDR) was observed in 42.4% of isolates, and 57.9% of Gram-negative bacteria were ESBL producers.These findings highlight the clinical significance of high MDR and ESBL prevalence, emphasizing challenges in empiric therapy and the importance of routine susceptibility testing among diabetic patients.