Drug Resistance Patterns and Pathogen Distribution in Patients with Urinary Tract Infection in Suzhou, China: A Five-Year Retrospective Study (2020–2024)

This five-year analysis of 9,249 positive urine cultures from UTI patients in Suzhou, China (2020–2024) found that infections predominantly affected women and older adults, with Escherichia coli as the leading pathogen, followed by Enterococcus faecalis, Klebsiella pneumoniae, and Enterococcus faecium. While E. coli showed a significant decline in resistance to third- and fourth-generation cephalosporins and a reduced prevalence of ESBL producers, resistance to fluoroquinolones remained persistently high. Of particular concern were marked fluctuations in carbapenem resistance in K. pneumoniae, peaking at over 40%, and the extreme, species-specific resistance of E. faecium to ampicillin and fluoroquinolones, which severely constrained treatment options. Among fungal pathogens, azole resistance decreased in Candida albicans but remained high in Candida tropicalis. Overall, the dynamic shifts in pathogen distribution and resistance patterns highlight the need for continuous local surveillance, refined empirical therapy, and strengthened antimicrobial stewardship to optimize UTI management.