A Review on Current Antibiotic Resistance Trends of Uropathogens in India, A Survey from Urology Department 2020 – 2025

A urinary tract infection is a bacterial infection in any part of the urinary system. UTIs range from uncomplicated lower urinary tract infections to complicated infections-which include pyelonephritis and urosepsis-and catheter-associated UTIs. It affects all ages and sex, though distribution varies by population subgroup including venerable population, for example, pregnant women, paediatrics, elderly. AMR heightens the treatment failure rate, recurrence, hospital length of stay, cost, and mortality, especially when first-line agents fail and reserve drugs are necessitated. WHO and Lancet analyses have documented that globally, AMR in UTIs is a critical concern; in high-burden LMICs, India also depicts a high prevalence of resistant Gram-negative Uropathogens and considerable inter-regional variability. Empiric oral therapy for uncomplicated cystitis should favour nitrofurantoin or fosfomycin where local susceptibility supports this. Fluoroquinolones should be de-emphasized for empiric community UTI in many regions. Increase in CRKP increases dependence on combination/last-line agents in severe infection; provides additional support for stewardship, infection control, and routine molecular epidemiology in tertiary settings. We anticipate a further increase in the production of ESBLs, continued rise of carbapenem resistance in Enterobacterales, increase in fluoroquinone resistance and significant regional variation all stressing the urgency for coordinated national efforts to support surveillance systems, promote antimicrobial stewardship, expand rapid diagnostic testing and reinforce infection control measures.