Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries

Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries Publisher Pubmed

Kianpour P ; Ranjbarian S ; Azimi Movahed F ; Hamedi S ; Mourtami R ; Qahari M ; Pourfakhr P ; Sharifnia H ; Mojtahedzadeh M ; Najmeddin F

Source: Microbial Drug Resistance Published:2025

Abstract

Background: Antimicrobial resistance is a critical global threat in resource-limited settings with underdeveloped laboratory capacity and stewardship programs. Intensive care unit (ICU) patients are at high risk for complicated urinary tract infections (cUTIs) caused by multidrug-resistant (MDR) uropathogens. Local resistance data are essential to guide empirical therapy and design effective stewardship interventions. Methods: We conducted a retrospective, cross-sectional study (March 2020–December 2022) of 127 adult ICU patients with cUTIs at a tertiary hospital in Tehran, Iran. Urine isolates were identified by standard phenotypic methods, and antimicrobial susceptibility testing (AST) was performed via disk diffusion following Clinical and Laboratory Standards Institute guidelines. Resistance phenotypes—extended-spectrum beta-lactamase (ESBL) production, carbapenem-resistant Enterobacteriaceae, vancomycin-resistant enterococci (VRE), difficult-to-treat Pseudomonas, and pan-drug-resistant (PDR) Acinetobacter baumannii—were defined using current breakpoints. Results: Escherichia coli (52.2%) and Klebsiella pneumoniae (26.9%) predominated. Among Enterobacterales, 60.4% produced ESBL and 30.2% were carbapenem resistant. VRE comprised all enterococcal isolates; PDR A. baumannii occurred in one case. No significant associations were found between resistance profiles and sepsis, septic shock, or mortality. Multivariable analysis identified heart failure (odds ratio [OR] 2.45; 95% confidence interval [CI] 1.15–5.21; p = 0.017) and longer ICU stay (OR 1.03 per day; 95% CI 1.01–1.05; p = 0.012) as independent predictors of MDR infection. Conclusions: We report an alarming burden of MDR uropathogens in Tehran ICUs, underscoring the need for tailored empirical-therapy guidelines, enhanced antimicrobial stewardship programs, and multicenter surveillance to curb resistance and improve patient outcomes. © 2025 Elsevier B.V., All rights reserved.

Style	Citing Format
MLA	Kianpour P, et al.. "Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries." Microbial Drug Resistance, vol. , no. , 2025, pp. -.
APA	Kianpour P, Ranjbarian S, Azimi Movahed F, Hamedi S, Mourtami R, Qahari M, Pourfakhr P, Sharifnia H, Mojtahedzadeh M, Najmeddin F (2025). Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries. Microbial Drug Resistance, (), -.
Chicago	Kianpour P, Ranjbarian S, Azimi Movahed F, Hamedi S, Mourtami R, Qahari M, Pourfakhr P, Sharifnia H, Mojtahedzadeh M, Najmeddin F. "Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries." Microbial Drug Resistance , no. (2025): -.
Harvard	Kianpour P et al. (2025) 'Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries', Microbial Drug Resistance, (), pp. -.
Vancouver	Kianpour P, Ranjbarian S, Azimi Movahed F, Hamedi S, Mourtami R, Qahari M, et al.. Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries. Microbial Drug Resistance. 2025;():-.
BibTex	@article{ author = {Kianpour P and Ranjbarian S and Azimi Movahed F and Hamedi S and Mourtami R and Qahari M and Pourfakhr P and Sharifnia H and Mojtahedzadeh M and Najmeddin F}, title = {Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries}, journal = {Microbial Drug Resistance}, volume = {}, number = {}, pages = {-}, year = {2025} }
RIS	TY - JOUR AU - Kianpour P AU - Ranjbarian S AU - Azimi Movahed F AU - Hamedi S AU - Mourtami R AU - Qahari M AU - Pourfakhr P AU - Sharifnia H AU - Mojtahedzadeh M AU - Najmeddin F TI - Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries JO - Microbial Drug Resistance VL - IS - SP - EP - PY - 2025 ER -

Style

Citing Format

MLA

Kianpour P, et al.. "Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries." Microbial Drug Resistance, vol. , no. , 2025, pp. -.

APA

Kianpour P, Ranjbarian S, Azimi Movahed F, Hamedi S, Mourtami R, Qahari M, Pourfakhr P, Sharifnia H, Mojtahedzadeh M, Najmeddin F (2025). Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries. Microbial Drug Resistance, (), -.

Chicago

Kianpour P, Ranjbarian S, Azimi Movahed F, Hamedi S, Mourtami R, Qahari M, Pourfakhr P, Sharifnia H, Mojtahedzadeh M, Najmeddin F. "Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries." Microbial Drug Resistance , no. (2025): -.

Harvard

Kianpour P et al. (2025) 'Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries', Microbial Drug Resistance, (), pp. -.

Vancouver

Kianpour P, Ranjbarian S, Azimi Movahed F, Hamedi S, Mourtami R, Qahari M, et al.. Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries. Microbial Drug Resistance. 2025;():-.

BibTex

@article{ author = {Kianpour P and Ranjbarian S and Azimi Movahed F and Hamedi S and Mourtami R and Qahari M and Pourfakhr P and Sharifnia H and Mojtahedzadeh M and Najmeddin F}, title = {Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries}, journal = {Microbial Drug Resistance}, volume = {}, number = {}, pages = {-}, year = {2025} }

RIS

TY - JOUR
AU - Kianpour P
AU - Ranjbarian S
AU - Azimi Movahed F
AU - Hamedi S
AU - Mourtami R
AU - Qahari M
AU - Pourfakhr P
AU - Sharifnia H
AU - Mojtahedzadeh M
AU - Najmeddin F
TI - Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries
JO - Microbial Drug Resistance
VL -
IS -
SP -
EP -
PY - 2025
ER -

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Authors

Abstract