Clinical Impact of Multidrug-Resistant Uropathogens in Urinary Tract Infections in Baghdad: A Cross-Sectional Study

Clinical Impact of Multidrug-Resistant Uropathogens in Urinary Tract Infections in Baghdad: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Impact of Multidrug-Resistant Uropathogens in Urinary Tract Infections in Baghdad: A Cross-Sectional Study Haider Hamid Khudiar This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9284867/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract UTIs are among the most widespread bacterial infections worldwide. The emergence of multi-drug resistant (MDR) uropathogenic bacteria has become a significant challenge in the treatment of UTIs in Baghdad hospitals, leading to increased morbidity, prolonged hospitalization, and elevated healthcare expenditures. To determine the frequency of MDR uropathogenic bacteria in adult patients with UTIs in selected hospitals in Baghdad, evaluate their clinical outcomes, characterize antimicrobial resistance, and assess clinical factors. A cross-sectional study from October 2025 through January 2026 at three hospitals in Baghdad. Patients admitted for suspected urinary tract infection and aged at least 18 years provided midstream urine samples. Samples were cultured, bacteria were identified using standard microbiological techniques, and antimicrobial susceptibility testing was performed using the Kirby–Bauer Disk Diffusion Method according to CLSI guidelines. MDR was defined as resistance to ≥3 antimicrobial classes. Data on demographics, medical history, prior antibiotic use, and hospitalizations were collected. Of 612 urine samples, 456 (74.5%) demonstrated significant growth. E. coli (58.8%), K. pneumoniae (18.0%), and P. aeruginosa (9.6%) were predominant. MDR prevalence was 63.2% (n=288), highest in K. pneumoniae (78.5%). Significant associations existed between MDR and recurrent UTI history (p<0.01), prior antibiotic exposure (p<0.01), and catheter use (p=0.02). MDR infections showed longer hospital stays (8.5 ± 3.1 vs 5.2 ± 2.4 days; p<0.001) and more complications. The high prevalence of MDR highlights the importance of antimicrobial stewardship, resistance monitoring, and the development of alternative therapeutic strategies. Multidrug resistance Uropathogens Urinary tract infection Antimicrobial susceptibility Clinical outcomes Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9284867","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":619031976,"identity":"88a81a62-67dc-4480-906e-8aa18aa4d9e0","order_by":0,"name":"Haider Hamid Khudiar","email":"data:image/png;base64,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","orcid":"","institution":"Mustansiriyah University","correspondingAuthor":true,"prefix":"","firstName":"Haider","middleName":"Hamid","lastName":"Khudiar","suffix":""}],"badges":[],"createdAt":"2026-04-01 00:08:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9284867/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9284867/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106373643,"identity":"acfcd85e-17ab-4143-aa83-7c3838557b9f","added_by":"auto","created_at":"2026-04-08 02:56:05","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":438561,"visible":true,"origin":"","legend":"","description":"","filename":"Originalarticle.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9284867/v1_covered_906c76c9-5990-40b9-a3ca-9ca5c51ae04c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Impact of Multidrug-Resistant Uropathogens in Urinary Tract Infections in Baghdad: A Cross-Sectional Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Multidrug resistance, Uropathogens, Urinary tract infection, Antimicrobial susceptibility, Clinical outcomes","lastPublishedDoi":"10.21203/rs.3.rs-9284867/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9284867/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"UTIs are among the most widespread bacterial infections worldwide. The emergence of multi-drug resistant (MDR) uropathogenic bacteria has become a significant challenge in the treatment of UTIs in Baghdad hospitals, leading to increased morbidity, prolonged hospitalization, and elevated healthcare expenditures. To determine the frequency of MDR uropathogenic bacteria in adult patients with UTIs in selected hospitals in Baghdad, evaluate their clinical outcomes, characterize antimicrobial resistance, and assess clinical factors. A cross-sectional study from October 2025 through January 2026 at three hospitals in Baghdad. Patients admitted for suspected urinary tract infection and aged at least 18 years provided midstream urine samples. Samples were cultured, bacteria were identified using standard microbiological techniques, and antimicrobial susceptibility testing was performed using the Kirby–Bauer Disk Diffusion Method according to CLSI guidelines. MDR was defined as resistance to ≥3 antimicrobial classes. Data on demographics, medical history, prior antibiotic use, and hospitalizations were collected. Of 612 urine samples, 456 (74.5%) demonstrated significant growth. E. coli (58.8%), K. pneumoniae (18.0%), and P. aeruginosa (9.6%) were predominant. MDR prevalence was 63.2% (n=288), highest in K. pneumoniae (78.5%). Significant associations existed between MDR and recurrent UTI history (p\u003c0.01), prior antibiotic exposure (p\u003c0.01), and catheter use (p=0.02). MDR infections showed longer hospital stays (8.5 ± 3.1 vs 5.2 ± 2.4 days; p\u003c0.001) and more complications. The high prevalence of MDR highlights the importance of antimicrobial stewardship, resistance monitoring, and the development of alternative therapeutic strategies.","manuscriptTitle":"Clinical Impact of Multidrug-Resistant Uropathogens in Urinary Tract Infections in Baghdad: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-08 02:55:33","doi":"10.21203/rs.3.rs-9284867/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a0972e05-72b5-4e6c-ae1e-f8d437ed0d4f","owner":[],"postedDate":"April 8th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-08T02:55:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-08 02:55:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9284867","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9284867","identity":"rs-9284867","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}