Antimicrobial Susceptibility of Urinary Tract Pathogens in a Resource-Limited Southern Nigerian Setting: Data to Inform Local Stewardship Frameworks

Abstract

Background: Urinary tract infections (UTIs) contribute substantially to infectious disease morbidity, while locally derived antimicrobial resistance data remain limited in many semi-urban Nigerian settings. This study assessed uropathogen prevalence and antimicrobial susceptibility at Igbinedion University Teaching Hospital, Okada, Nigeria, to support local stewardship and empirical treatment decisions. Methods: A retrospective review of archived microbiology records from March 2022 to January 2025 included urine samples submitted for culture and susceptibility testing. Culture positivity, organism distribution, gender distribution, and resistance patterns were analysed. Antimicrobial susceptibility testing used the Kirby–Bauer disk diffusion method with CLSI 2021 breakpoints. Results: Of 571 urine samples, 442 (77.4%) showed significant microbial growth. Female patients contributed 439 samples (76.9%). Staphylococcus aureus was the most frequently isolated organism (222; 50.2%), followed by Escherichia coli (160; 36.2%). The predominance of S. aureus requires cautious interpretation because contamination, referral-centre case mix, and local identification practices may have contributed. Resistance was highest to erythromycin (96.6%) and nitrofurantoin (88.4%), whereas ciprofloxacin showed comparatively higher susceptibility. Conclusion: The findings indicate a high burden of bacteriuria and antimicrobial resistance in this hospital population. Routine urine culture, locally generated antibiograms, and structured antimicrobial stewardship are warranted. Erythromycin and nitrofurantoin appear unreliable for empirical treatment at this facility, while fluoroquinolone use should remain cautious and culture guided.