{ "abstract": "Urinary tract infections (UTIs) are a common indication for antibiotic use among adult outpatients in low- and middle-income countries, yet data on community-acquired UTIs (CA-UTIs) and antimicrobial resistance at primary healthcare facilities remain limited. A facility-based cross-sectional study was conducted from May to August 2024 at Igoma and Buzuruga Health Centres in Mwanza, Tanzania. Symptomatic adults without hospitalization within the preceding 30 days or urinary catheterization were enrolled. Clinical and demographic data were collected, and midstream urine specimens were cultured, followed by antimicrobial susceptibility testing using the disc diffusion method. Of 1,005 participants, the median age was 32 years [IQR: 23–49], 727 (72.3%) were female, and 64.3% reported to have been diagnosed with UTI within the previous six months. The median symptom duration before presentation was 8 days [IQR: 5–15]. Culture-confirmed UTI was detected in 221 participants (22.0%; 95% CI: 19.5–24.7), with Escherichia coli (32.9%) and Staphylococcus aureus (24.7%) being the most frequently isolated pathogens. Only 35.7% of culture-confirmed cases are presented with classic urinary symptoms of dysuria, frequency, or urgency. E. coli showed high resistance to ampicillin (93.4%), ciprofloxacin (62.3%), trimethoprim-sulfamethoxazole (60.7%), amoxicillin-clavulanic acid (57.4%), and tetracycline (55.7%); 82.8% were multidrug-resistant and 20.3% exhibited extended-spectrum beta-lactamase phenotypes. Among S. aureus isolates, 64.6% were cefoxitin-resistant, indicating methicillin resistance. CA-UTIs therefore constitutes a substantial burden among adult primary-care outpatients, accompanied by high antimicrobial resistance and frequent atypical clinical presentations. Improved access to UTI diagnostics, strengthened antimicrobial stewardship, and locally informed treatment guidelines are needed, particularly given the high resistance to commonly used empirical antibiotics.", "abstract_shown": true, "affiliations": [ "Weil Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania", "Pharmacy Department, Igoma Health Centre, Mwanza, Tanzania", "Department of Biochemistry and Molecular Biology Catholic University of Health and Allied Sciences, Mwanza, Tanzania", "Department of Epidemiology, Biostatistics and Behavioural science, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania", "Department of Microbiology and immunology, Weil Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania" ], "article_type": "Research Article", "arxiv": null, "author_total": 11, "authors": [ { "affs": [ 0 ], "name": "Eunice G. Emmanuel" }, { "affs": [ 1 ], "name": "Ashura Khamis" }, { "affs": [ 2 ], "name": "Elikana Michael" }, { "affs": [ 3 ], "name": "Dorina Muhizi" }, { "affs": [ 4 ], "name": "James Thomas" }, { "name": "Bernard Okamo" }, { "name": "Farida I. Mkassy" }, { "name": "Eveline T. Konje" }, { "name": "Vitus Silago" }, { "name": "Martha F. Mushi" }, { "name": "Stephen E. Mshana" } ], "bibtex": "https://research.draconitic.com/paper/fx9rag8kztmhj.bib", "cited_by": 0, "doi": "10.1371/journal.pgph.0005638", "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005638", "id": "fx9rag8kztmhj", "issns": [ "2767-3375" ], "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005638", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2713|Urinary Tract Infections Management" ], [ "plos", "/Biology and life sciences/Anatomy/Body fluids/Urine" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Bacterial pathogens" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Bacterial pathogens/Escherichia coli" ], [ "plos", "/Biology and life sciences/Microbiology/Microbial control/Antimicrobial resistance" ], [ "plos", "/Biology and life sciences/Microbiology/Microbial control/Antimicrobial resistance/Antibiotic resistance" ], [ "plos", "/Biology and life sciences/Microbiology/Microbial control/Antimicrobials/Antibiotics" ], [ "plos", "/Biology and life sciences/Organisms/Bacteria/Enterobacteriaceae/Escherichia/Escherichia coli" ], [ "plos", "/Biology and life sciences/Organisms/Bacteria/Gut bacteria/Escherichia/Escherichia coli" ], [ "plos", "/Biology and life sciences/Physiology/Body fluids/Urine" ], [ "plos", "/Medicine and health sciences/Anatomy/Body fluids/Urine" ], [ "plos", "/Medicine and health sciences/Health care/Health care facilities" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Bacterial pathogens" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Bacterial pathogens/Escherichia coli" ], [ "plos", "/Medicine and health sciences/Pharmacology/Antimicrobial resistance" ], [ "plos", "/Medicine and health sciences/Pharmacology/Antimicrobial resistance/Antibiotic resistance" ], [ "plos", "/Medicine and health sciences/Pharmacology/Drugs/Antimicrobials/Antibiotics" ], [ "plos", "/Medicine and health sciences/Urology/Genitourinary infections/Urinary tract infections" ], [ "plos", "/Research and analysis methods/Animal studies/Experimental organism systems/Model organisms/Escherichia coli" ], [ "plos", "/Research and analysis methods/Animal studies/Experimental organism systems/Prokaryotic models/Escherichia coli" ], [ "plos", "/Research and analysis methods/Model organisms/Escherichia coli" ] ], "openalex": "W7221057794", "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0005638&type=printable", "pmcid": null, "pmid": null, "published": "2026-10-08", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/fx9rag8kztmhj.ris", "sources": [ { "first_seen": "2026-10-30T12:17:30Z", "native_id": "10.1371/journal.pgph.0005638", "source": "plos", "url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005638" } ], "subjects": [ { "field": "biology", "origin": "plos:microbiology", "subfield": "microbiology" }, { "field": "medicine", "origin": "plos:pharmacology", "subfield": "pharmacology-toxicology" }, { "field": "medicine", "origin": "plos:anatomy", "subfield": "physiology" } ], "title": "Multidrug resistance in bacteria causing community-acquired urinary tract infections among adult outpatients attending primary healthcare facilities in Mwanza, Tanzania", "title_text": "Multidrug resistance in bacteria causing community-acquired urinary tract infections among adult outpatients attending primary healthcare facilities in Mwanza, Tanzania", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:30Z", "url": "https://research.draconitic.com/paper/fx9rag8kztmhj", "venue": "PLOS Global Public Health", "versions": [] }