Retrospective study finds low resistance to key antibiotics in TB patients with UTIs

This retrospective cohort study analyzed 1,151 bacterial strains from tuberculosis patients complicated with urinary tract infections at a single hospital, focusing on bacterial distribution and antimicrobial susceptibility testing. The population involved strains from these patients, with no comparator group reported. Bacterial identification showed Gram-negative strains accounted for 76.3% (878 strains) and Gram-positive strains for 23.7% (273 strains), with Escherichia coli at 34.9% and Klebsiella pneumoniae at 22.2% as the most prevalent pathogens. Enterococcus faecium made up 15.6% of strains.

Main results indicated low resistance rates: for Escherichia coli, resistance to cefoperazone/sulbactam, amikacin, tigecycline, and carbapenems was below 5%, and for Klebsiella pneumoniae, tigecycline resistance was 0%. Enterococcus faecium showed resistance rates under 5% to quinupristin/dalfopristin, linezolid, high concentrations of streptomycin and gentamicin, tigecycline, and vancomycin. Additionally, Klebsiella pneumoniae resistance rates to multiple antimicrobials were significantly higher in male patients than females, with all p-values reported but exact numbers not provided.

Safety and tolerability data were not reported. Key limitations include the retrospective, single-center design, lack of comparator, and unspecified follow-up, which may limit generalizability. The study provides evidence-based support for rational antimicrobial use in this population, but findings are observational and should not be overinterpreted as causal. Clinicians should consider these data alongside local resistance patterns and patient-specific factors when treating UTIs in tuberculosis patients.