CRACKING THE CODE OF RESISTANCE: CARBAPENEM-RESISTANT URINARY TRACT INFECTIONS IN PUBLIC AND PRIVATE HOSPITALS

Authors

• Shaista Bakhat, Department of Pathology, Faculty of BUHSC, Bahria University Health Sciences Campus, Karachi, PakistanFollow
• Fakhur Uddin, Microbiology Department, Faculty of BMSI, JPMC, Karachi, Pakistan
• Muhammad Sohail, Department of Microbiology, University of Karachi, Karachi, Pakistan
• Shehla M. Baqai, Gynae and Obs, BUHSC, Karachi, Pakistan
• Naresh Kumar, Urology Department, Jinnah Postgraduate Medical Center, Karachi, Pakistan
• Saman Nadeem, Microbiology Department, NMC, Karachi, Pakistan

ORCID ID

Shaista Bakhat: https://orcid.org/0000-0002-4180-0026

Fakhur Uddin: https://orcid.org/0000-0002-2858-674X

Muhammad Sohail: https://orcid.org/0000-0002-7208-9441

Shehla M. Baqai: https://orcid.org/0000-0001-8248-1132

Naresh Kumar: https://orcid.org/0009-0006-8659-9318

Saman Nadeem: https://orcid.org/0000-0002-5154-1873

Abstract

This research aimed to analogize the resistance patterns against carbapenem antibiotics in Enterobacterales uropathogens between two healthcare facilities. The authors performed this study at the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center, and the National Medical Center. A total of 374 UTI patients were enrolled, equally distributed in the two centers (187 each hospital). Molecular assays supplemented phenotypic susceptibility testing to detect carbapenem resistance. Statistical analysis, including multivariate logistic regression, was performed to identify associations between hospital type and carbapenem resistance. Of 374 urine samples, CA-UTIs were found in 86 (23.1%) and 90 (24%), while HA-UTIs occurred in 101 (26.9%) and 97 (26%) cases in JPMC and NMC, respectively. At JPMC, 170 samples (91%) demonstrated growth, yielding 180 isolates. At NMC, 130 samples (70%) grew positively, yielding 135 isolates. Out of 180 isolates from JPMC, 150 (83%) were Enterobacterales. Meanwhile, the NMC samples, 90 isolates of 135 (67%), were Enterobacterales. The prevalence of Carbapenem-resistant Enterobacterales was higher in JPMC samples (120; 80%) than in NMC samples (69; 77%). blaNDM was more frequent in isolates from JPMC (78; 65%) than in those of NMC (7; 10%), with p-value ≤ 0.0001. In contrast, bla_KPC was more prevalent in isolates from NMC (40; 58%) than in those from JPMC (18; 15%) (p ≤ 0.0001). bla_OXA-181 was slightly higher in number (13; 11%) in JPMC isolates than in the NMC (4; 6%) isolates (p = 0.025). The analysis revealed that previous carbapenem use was the only consistent risk factor for carbapenem-resistant infections at both JPMC and NMC. The study indicated an alarmingly high prevalence of carbapenem resistance across both healthcare settings. bla_NDM-producing organisms were more frequently identified in the public sector, whereas bla_KPC-harboring pathogens predominated in the private sector.

Keywords

blaNDM, blaKPC, blaOXA-181, Carbapenem resistance, Health, Uropathogens

First Page

79

Last Page

90

DOI

10.65346/2599-056X.2432

Publication Date

6-30-2026

Recommended Citation

Bakhat, Shaista; Uddin, Fakhur; Sohail, Muhammad; Baqai, Shehla M.; Kumar, Naresh; and Nadeem, Saman. 2026 CRACKING THE CODE OF RESISTANCE: CARBAPENEM-RESISTANT URINARY TRACT INFECTIONS IN PUBLIC AND PRIVATE HOSPITALS. Folia Medica Indonesiana. 62, 1 (Jun. 2026 ), 79-90.
Available at: https://doi.org/10.65346/2599-056X.2432