Multi-drug resistance and multiple antibiotic resistance index of uropathogens in diabetic and non-diabetic patients with urinary tract infections
- 1Department of Medical Laboratory and Life Sciences, Parul Institute of Allied and Healthcare Sciences, Faculty of Medicine, Parul University, Vadodara, Gujarat 391760 India
Abstract
Aim: This study aimed to determine the multidrug resistance (MDR) rate and multiple antibiotic resistance index (MARI) of uropathogens among diabetic and non-diabetic patients with urinary tract infections (UTIs), highlighting the global concern for empirical treatment decisions.
Method: A prospective study was conducted from August 2021 to January 2024 in Gujarat, India, involving 2,408 patients with UTI symptoms, of whom 954 tested positives for UTIs. Among these, 280 (27%) were diabetic, and 674 (73%) were non-diabetic.
Results: In diabetic patients, Pseudomonas aeruginosa (P. aeruginosa) was more common in males, while Escherichia coli (E. coli) was more frequent in younger (18–40) females causing bacteriuria. Candida non-albicans which causes Candiduria was also found to be a prevalent pathogen in patients aged 61–95 and tended to recur. In non-diabetic patients, younger females were predominantly infected with E. coli, whereas males had higher rates of infections with P. aeruginosa and Klebsiella spp. Recurrence was strongly associated with E. coli in non-diabetics. Diabetic patients exhibited higher rates of antibiotic-resistant uropathogens compared to non-diabetics. Among the isolates, 61.84% were MDR, 19.49% were extreme drug-resistant (XDR), and 12.99% were pan drug-resistant (PDR). P. aeruginosa showed 92.10% MDR in diabetics, while E. coli showed 70.99% MDR in non-diabetics. XDR was more common in P. aeruginosa, while PDR was higher in Klebsiella spp. and P. aeruginosa. MARI greater than 0.2 was observed in 87.01% (201/231) of gram-negative uropathogens in diabetics and 71.03% (412/580) in non-diabetics.
Conclusion: The study highlights significant differences in uropathogen prevalence and antibiotic resistance pattern between diabetic and non-diabetic UTI patients, emphasizing the need for targeted management and enhanced surveillance.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12941-026-00866-3.
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BibTeX
@article{kalola2026multidrug,
title = {{Multi-drug resistance and multiple antibiotic resistance index of uropathogens in diabetic and non-diabetic patients with urinary tract infections}},
author = {Priyal Kalola and Hemantkumar Patadia and Ankita Priyadarshini},
journal = {Annals of Clinical Microbiology and Antimicrobials},
year = {2026},
month = jul,
doi = {10.1186/s12941-026-00866-3},
url = {https://doi.org/10.1186/s12941-026-00866-3},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Multi-drug resistance and multiple antibiotic resistance index of uropathogens in diabetic and non-diabetic patients with urinary tract infections
AU - Priyal Kalola
AU - Hemantkumar Patadia
AU - Ankita Priyadarshini
PY - 2026
DA - 2026/07/23
JO - Annals of Clinical Microbiology and Antimicrobials
DO - 10.1186/s12941-026-00866-3
UR - https://doi.org/10.1186/s12941-026-00866-3
AB - Aim: This study aimed to determine the multidrug resistance (MDR) rate and multiple antibiotic resistance index (MARI) of uropathogens among diabetic and non-diabetic patients with urinary tract infections (UTIs), highlighting the global concern for empirical treatment decisions. Method: A prospective study was conducted from August 2021 to January 2024 in Gujarat, India, involving 2,408 patients with UTI symptoms, of whom 954 tested positives for UTIs. Among these, 280 (27%) were diabetic, and 674 (73%) were non-diabetic. Results: In diabetic patients, Pseudomonas aeruginosa (P. aeruginosa) was more common in males, while Escherichia coli (E. coli) was more frequent in younger (18–40) females causing bacteriuria. Candida non-albicans which causes Candiduria was also found to be a prevalent pathogen in patients aged 61–95 and tended to recur. In non-diabetic patients, younger females were predominantly infected with E. coli, whereas males had higher rates of infections with P. aeruginosa and Klebsiella spp. Recurrence was strongly associated with E. coli in non-diabetics. Diabetic patients exhibited higher rates of antibiotic-resistant uropathogens compared to non-diabetics. Among the isolates, 61.84% were MDR, 19.49% were extreme drug-resistant (XDR), and 12.99% were pan drug-resistant (PDR). P. aeruginosa showed 92.10% MDR in diabetics, while E. coli showed 70.99% MDR in non-diabetics. XDR was more common in P. aeruginosa, while PDR was higher in Klebsiella spp. and P. aeruginosa. MARI greater than 0.2 was observed in 87.01% (201/231) of gram-negative uropathogens in diabetics and 71.03% (412/580) in non-diabetics. Conclusion: The study highlights significant differences in uropathogen prevalence and antibiotic resistance pattern between diabetic and non-diabetic UTI patients, emphasizing the need for targeted management and enhanced surveillance. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12941-026-00866-3.
SN - 1476-0711
ER -