Empirical Analysis of Antimicrobial Resistance Patterns in Urinary Tract Infections at Tertiary Hospitals in Kaduna State, North West Nigeria

Antimicrobial resistance in urinary tract infections caused by gram-negative uropathogens is an escalating clinical challenge in Nigerian tertiary hospitals. Empirical evidence on local resistance patterns is essential for formulating evidence-based antibiotic prescribing guidelines. This study analyzed antimicrobial resistance patterns among urinary tract infection isolates at tertiary hospitals in Kaduna State, North West Nigeria. A laboratory-based retrospective study was conducted using urinary culture and sensitivity records from two tertiary hospitals over a 36-month period. A total of 1,850 urine samples with significant growth were analyzed for uropathogen species distribution, antibiotic susceptibility profiles, and extended-spectrum beta-lactamase production rates. Escherichia coli was the most prevalent isolate at 42 percent, followed by Klebsiella pneumoniae at 23 percent. Resistance to ampicillin exceeded 85 percent across all isolates, and resistance to ciprofloxacin, a commonly prescribed oral antibiotic, was recorded at 61 percent. Extended-spectrum beta-lactamase producers constituted 38 percent of Escherichia coli isolates. Nitrofurantoin and fosfomycin retained activity against more than 70 percent of isolates. These resistance profiles indicate that empiric treatment regimens currently in use may be substantially ineffective. The study recommends adoption of local antibiograms as the basis for empiric antibiotic selection in Kaduna State hospitals and advocates for pharmacist engagement in antibiotic stewardship activities targeting urinary tract infection management. Development of annual resistance surveillance reports by hospital pharmacy departments is also recommended. Keywords: antimicrobial resistance, urinary tract infections, Kaduna State, antibiogram, extended-spectrum beta-lactamase