Gender-Driven UTI Epidemiology and Pan-Resistance Challenges: Cross-Sectional Insights from District Okara Hospitals

Abstract

Urinary tract infections (UTIs) are common bacterial infections with gender-based prevalence differences. This hospital-based cross-sectional study in District Okara, Pakistan, assessed UTI prevalence by gender, demographics, and antimicrobial resistance trends using questionnaires (n=307) and lab analysis (n=35 urine samples). Of 307 patients, 124 (40.4%) tested positive for UTI. Females showed higher prevalence: 73/112 (65.2%) vs. 51/195 (26.2%) in males (p<0.05). Age had no significant impact—44.0% positivity in 10-40 years and 37.9% in 41-70 years (p=0.287). Residence was insignificant (39.3% urban vs. 41.4% rural; p=0.709), but marital status mattered: 43.2% in married vs. 37.2% in unmarried (p<0.05). Escherichia coli was the dominant pathogen, identified via MacConkey agar, Gram staining, and biochemical tests; Pseudomonas and Proteus spp. were also non-lactose fermenting. Antibiotic susceptibility testing (Kirby-Bauer disk diffusion) on 15 common antibiotics revealed alarming resistance: ~100% to ampicillin, amoxicillin-clavulanate, ceftriaxone, cefepime, ciprofloxacin, nitrofurantoin, fosfomycin, trimethoprim-sulfamethoxazole, gentamicin, amikacin, imipenem, meropenem, colistin, and doxycycline—indicating multidrug-resistant (MDR) strains. Key findings: (1) UTIs disproportionately affect females, highlighting gender as a risk factor; (2) age/residence insignificant, but marital status influences occurrence; (3) widespread MDR, including to last-resort drugs like carbapenems and colistin. In conclusion, UTIs pose a major health issue in Okara, especially for females, with high resistance complicating treatment.