Antimicrobial Susceptibility Patterns and Proportion of Multidrug‐Resistant Uropathogens in a Remote Tertiary Hospital in Bhutan: A Cross‐Sectional Study

ABSTRACT Background and Aims A surge in antimicrobial resistance and multidrug‐resistant organisms among uropathogens have complicated its management over time. It is imperative to examine epidemiology and local antimicrobial susceptibility patterns to promote evidence‐based management. This study aimed to evaluate the antimicrobial susceptibility patterns of uropathogens and proportion of multidrug‐resistant organisms at a remote tertiary hospital in Bhutan. Methods A cross‐sectional study was conducted in the Microbiology Laboratory of a remote tertiary hospital in Bhutan, by retrospectively reviewing medical records of patients who underwent urine culture and sensitivity testing from January 1 to December 31, 2025. All culture ‐ positive (≥ 10 5 CFU/mL) samples were included in the study. Data were collected using a structured proforma and analyzed using SPSS version 23. Results A total of 1867 urine samples were analyzed, of which 19.9% were culture positive. Culture positivity was more common in female (85.8%), and older than 40 years (55%). Gram‐negative bacteria constituted the majority (98.4%), with E. coli (80.6%) being the most frequently isolated pathogen, followed by Klebsiella pneumoniae (15.6%). E. coli demonstrated high sensitivity to Access group‐gentamicin (81.1%) and Watch group‐Imipenem (84.2%). Nearly two‐fifths of the uropathogen isolates were multidrug‐resistant (39.2%), and a few isolates were carbapenem‐resistant organism (8.2%). Multidrug‐resistant uropathogens were significantly reported from hospitalized patients (77.4% vs 22.6%, p < 0.001). On multivariable analysis, inpatient status was the only independent predictor of multidrug‐resistant organisam isolation (aOR 2.4, 95% CI 1.34–4.37, p = 0.003). Conclusion Most of the culture positive were caused by Gram‐negative bacteria‐ E. coli demonstrating high susceptibility to gentamicin. Multidrug‐resistant organisms were prevalent in nearly two‐fifths of the isolates. These findings provide baseline data to guide empirical therapy and support antimicrobial stewardship program.