Cross-Sectional Investigation of Pathogenic Bacteria Associated with Urinary Tract Infections in Women in AL-Najaf City, Iraq
DOI:
https://doi.org/10.36320/ajb/v18.i1.23065Keywords:
Cross-Sectional, Investigation, UTI, WomenAbstract
Background: Urinary tract infections (UTIs) are the most frequent bacterial infection in women and an important public health issue because of their recurrent nature and rising antimicrobial resistance. This research was conducted to find the bacterial causes of UTI in women, and to determine the resistance pattern including MDR, XDR and ESBL production. Methods: One hundred and forty urine samples were obtained from women with confirmed UTIs. Bacterial isolation and identification of the bacterial isolates was carried out as per standard microbiological procedures including Gram staining followed by biochemical characterization. Susceptibilities to antibiotics were tested by the disk diffusion method. Patterns of resistance were categorized as XDR, MDR, or non-MDR, and ESBL production in Gram negative isolates was detected phenotypically. Results: A total of 157 bacterial isolates were recovered from a population of 140 urine samples: the presence of Gram-positive bacteria was observed more frequently than Gram-negative ones. Most of the isolates were related to chronic UTIs, predominantly among women aged 21-30 years and more commonly in married and pregnant women. The predominant pathogens were Enterococcus faecalis and Staphylococcus aureus. The rates of resistance to commonly used antibiotics were also very high with 61.2% and 28% isolates being classified as MDR and XDR respectively. Ciprofloxacin and imipenem were most potent antimicrobial agents among the tested. Conclusion: This study demonstrates the prevalence of chronic UTIs with a shift toward Gram-positive uropathogens and high prevalence of antimicrobial resistance, justifying regular susceptibility testing in addition to rational use of antibiotics.
Downloads
References
1- Advani, S. D., Thaden, J. T., Perez, R., Stair, S. L., Lee, U. J., & Siddiqui, N. Y. (2025). State-of-the-art review: Recurrent uncomplicated urinary tract infections in women. Clinical Infectious Diseases, 80(3), e31–e42.
2- Wagenlehner, F., Caballero, V. R., Maheshwari, V., Biswas, A., Saini, P., Quevedo, J., Polifka, J., Ruiz, L., & Cure, S. (2025). Efficacy of treatment options for complicated urinary tract infections including acute pyelonephritis: A systematic literature review and network meta-analysis. Journal of Comparative Effectiveness Research, 14(3), e240214.
3- Advani, S. D., Thaden, J. T., Perez, R., Stair, S. L., Lee, U. J., & Siddiqui, N. Y. (2025). State-of-the-art review: Recurrent uncomplicated urinary tract infections in women. Clinical Infectious Diseases, 80(3), e31–e42.
4- Alkhirsan, O. A., & Aljanaby, A. A. J. (2025). Azurocidin and CXCL9 as novel biomarkers in women with asymptomatic bacteriuria. Egyptian Journal of Medical Microbiology, 34(3).
5- Moreland, R. B., Brubaker, L., Tinawi, L., & Wolfe, A. J. (2025). Rapid and accurate testing for urinary tract infection: New clothes for the emperor. Clinical Microbiology Reviews, 38(1), e00129-24.
6- Daikos, G. L., Cisneros, J. M., Carmeli, Y., Wang, M., Leong, C. L., Pontikis, K., Anderzhanova, A., Florescu, S., Kozlov, R., Rodriguez-Noriega, E., & Psichogiou, M. (2025). Aztreonam–avibactam for the treatment of serious infections caused by metallo-β-lactamase-producing Gram-negative pathogens: A phase 3 randomized trial (ASSEMBLE). JAC–Antimicrobial Resistance, 7(4), dlaf131.
7- Bilsen, M. P., Jongeneel, R. M., Schneeberger, C., Platteel, T. N., Van Nieuwkoop, C., Mody, L., Caterino, J. M., Geerlings, S. E., Köves, B., Wagenlehner, F., & Conroy, S. P. (2023). Definitions of urinary tract infection in current research: A systematic review. Open Forum Infectious Diseases, 10(7), ofad332.
8- Nasrollahian, S., Graham, J. P., & Halaji, M. (2024). A review of the mechanisms that confer antibiotic resistance in pathotypes of Escherichia coli. Frontiers in Cellular and Infection Microbiology, 14, 1387497.
9- Clarke, K., Hall, C. L., Wiley, Z., Tejedor, S. C., Kim, J. S., Reif, L., Witt, L., & Jacob, J. T. (2020). Catheter-associated urinary tract infections in adults: Diagnosis, treatment, and prevention. Journal of Hospital Medicine, 15(9), 552–556.
10- Mong, I., Ramoo, V., Ponnampalavanar, S., Chong, M. C., & Wan Nawawi, W. N. (2022). Knowledge, attitude and practice in relation to catheter-associated urinary tract infection prevention: A cross-sectional study. Journal of Clinical Nursing, 31(1–2), 209–219.
11- Alkhalidi, T. K., & Aljanaby, A. A. J. (n.d.). Vascular endothelial growth factor and neutrophil gelatinase-associated lipocalin as critical biomarkers in patients with burn injury. Egyptian Journal of Medical Microbiology, 34(3).
12- Khayoon, S. Q., Aljanaby, A. A. J., & Al-Hadraawy, S. K. (2025). Neutrophil gelatinase-associated lipocalin and chemokine CXC motif ligand-1 as novel biomarkers in patients infected with a co-infection of Escherichia coli O157:H7 and Entamoeba histolytica. Egyptian Journal of Medical Microbiology, 34(3).
13- Aljanaby, A. J. (2022). Assessment of β-lactams and carbapenems antimicrobial resistance in Klebsiella oxytoca isolated from patients with urinary tract infections in Najaf, Iraq. Archives of Razi Institute, 77(2), 669.
14- Alotaibi, B. S., Tantry, B. A., Farhana, A., Alammar, M. A., Shah, N. N., Mohammed, A. H., Wani, F., & Bandy, A. (2023). Resistance pattern in mostly Gram-negative bacteria causing urinary tract infections. Infectious Disorders – Drug Targets, 23(2), 56–64.
15- Wilkowski, P., Hryniewiecka, E., Jasińska, K., & Ciszek, M. (2023). Multidrug-resistant strains as etiological agents of urinary tract infections in organ transplant recipients. Przegląd Epidemiologiczny, 77(2), 127–135.
16- Macha, M. E., Kohler, P., Bösch, A., Urassa, H. M., Qi, W., Seiffert, S. N., Haller, S., West, E., Rohacek, M. W., & Babouee Flury, B. (2025). High rate of multidrug-resistant Escherichia coli isolated from patients with urinary tract infections in Ifakara, Tanzania. Antimicrobial Resistance & Infection Control, 14(1), 41.
17- Confederat, L. G., Condurache, M. I., Alexa, R. E., & Dragostin, O. M. (2023). Particularities of urinary tract infections in diabetic patients: A concise review. Medicina, 59(10), 1747.
18- Rizwan, M., Akhtar, M., Najmi, A. K., & Singh, K. (2018). Escherichia coli and Klebsiella pneumoniae sensitivity/resistance pattern towards antimicrobial agents in primary and simple urinary tract infection patients. Drug Research, 68(7), 415–420.
19- Maitra, K., Degraft-Johnson, J., Singh, K. K., & Tsui, A. O. (2001). Prevalence of self-reported symptoms of reproductive tract infections among recently pregnant women in Uttar Pradesh, India. Journal of Biosocial Science, 33(4), 585–601.
20- Wang, Y., Sholeh, M., Yang, L., Shakourzadeh, M. Z., Beig, M., & Azizian, K. (2025). Global trends of ceftazidime–avibactam resistance in Gram-negative bacteria: A systematic review and meta-analysis. Antimicrobial Resistance & Infection Control, 14(1), 10.
21- Genet, C., Enbiale, W., Rommerskirchen, A., Abubeker, R., Tafere, W., Gebre-Eyesus, T., Getie, M., Tsega, A., Acham, M., Melese, A., & Awoke, T. (2025). Prevalence of extended-spectrum β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in raw bulk cow milk. PLoS ONE, 20(11), e0336987.
22- Eibach, D., Campos, C. B., Krumkamp, R., Al-Emran, H. M., Dekker, D., Boahen, K. G., Kreuels, B., Adu-Sarkodie, Y., Aepfelbacher, M., Park, S. E., & Panzner, U. (2016). Extended-spectrum beta-lactamase-producing Enterobacteriaceae causing bloodstream infections in rural Ghana, 2007–2012. International Journal of Medical Microbiology, 306(4), 249–254.
23 Godijk, N. G., McDonald, S. A., Altorf-Van der Kuil, W., Schoffelen, A. F., Franz, E., & Bootsma, M. C. J. (2023). New methodology to assess the excess burden of antibiotic resistance using country-specific parameters: A case study regarding Escherichia coli urinary tract infections. BMJ Open, 13(12), e064335.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ahmed Aljanaby, Nawres Humadi Hussein AL-essa
This work is licensed under a Creative Commons Attribution 4.0 International License.
which allows users to copy, create extracts, abstracts, and new works from the Article, alter and revise the Article, and make commercial use of the Article (including reuse and/or resale of the Article by commercial entities), provided the user gives appropriate credit (with a link to the formal publication through the relevant DOI), provides a link to the license, indicates if changes were made and the licensor is not represented as endorsing the use made of the work.
