Study on pathogenic bacteria distribution and antimicrobial resistance in adult urinary tract infections in a tertiary hospital in Southern Jiangxi, China, 2021–2024

Background Urinary tract infections (UTIs) are common global bacterial infections. Rising antimicrobial resistance complicates their treatment. Analyzing pathogen distribution and resistance patterns in southern Jiangxi, China, is crucial for informing empirical treatment and infection management. Methods We conducted a retrospective study of 3,212 urinary isolates from adult UTI patients at our hospital from January 2021 to December 2024. We used WHONET 5.6 software to analyze the distribution of pathogens and antimicrobial resistance patterns, and compared these patterns across different years, age groups, genders, and wards using the χ² test. Results Gram-negative bacteria predominated (75.37%). Escherichia coli was the most prevalent at 49.00%, with Klebsiella pneumoniae following at 9.34%. Carbapenem-resistant Klebsiella pneumoniae (CRKP) increased significantly. Its resistance to imipenem rose from 4.2% in 2021 to 24.5% in 2024. Vancomycin-resistant Enterococcus faecium (VREfm) emerged, reaching 9.4% in 2024. CRKP resistance was highest in Intensive Care Units (ICUs) (30.8%), compared with other clinical departments. Conclusion This study systematically analyzes the dynamic changes in pathogen profiles and antimicrobial resistance of adult urinary tract infections in southern Jiangxi from 2021 to 2024. It highlights the concurrent, rapid rise of CRKP and VREfm. The findings show a serious threat from multidrug-resistant bacteria, urging targeted infection control and antimicrobial stewardship.