{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:42:19Z","timestamp":1792406539927,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>A surge in antimicrobial resistance and multidrug\u2010resistant organisms among uropathogens have complicated its management over time. It is imperative to examine epidemiology and local antimicrobial susceptibility patterns to promote evidence\u2010based management. This study aimed to evaluate the antimicrobial susceptibility patterns of uropathogens and proportion of multidrug\u2010resistant organisms at a remote tertiary hospital in Bhutan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional 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 \u2010 positive (\u2265\u200910\n                      <jats:sup>5<\/jats:sup>\n                      CFU\/mL) samples were included in the study. Data were collected using a structured proforma and analyzed using SPSS version 23.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2010negative bacteria constituted the majority (98.4%), with\n                      <jats:italic>E. coli<\/jats:italic>\n                      (80.6%) being the most frequently isolated pathogen, followed by\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (15.6%).\n                      <jats:italic>E. coli<\/jats:italic>\n                      demonstrated high sensitivity to Access group\u2010gentamicin (81.1%) and Watch group\u2010Imipenem (84.2%). Nearly two\u2010fifths of the uropathogen isolates were multidrug\u2010resistant (39.2%), and a few isolates were carbapenem\u2010resistant organism (8.2%). Multidrug\u2010resistant uropathogens were significantly reported from hospitalized patients\u00a0(77.4% vs 22.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). On multivariable analysis, inpatient status was the only independent predictor of multidrug\u2010resistant organisam isolation (aOR 2.4, 95% CI 1.34\u20134.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Most of the culture positive were caused by Gram\u2010negative bacteria\u2010\n                      <jats:italic>E. coli<\/jats:italic>\n                      demonstrating high susceptibility to gentamicin. Multidrug\u2010resistant organisms were prevalent in nearly two\u2010fifths of the isolates. These findings provide baseline data to guide empirical therapy and support antimicrobial stewardship program.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73364","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:48:35Z","timestamp":1791442115000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial Susceptibility Patterns and Proportion of Multidrug\u2010Resistant Uropathogens in a Remote Tertiary Hospital in Bhutan: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2520-9973","authenticated-orcid":false,"given":"Sanga","family":"Tenzin","sequence":"first","affiliation":[{"name":"Department of Pharmacy Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7324-3028","authenticated-orcid":false,"given":"Yeshey","family":"Dorjey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5609-9981","authenticated-orcid":false,"given":"Pelden","family":"Wangchuk","sequence":"additional","affiliation":[{"name":"Office of the Medical Superintendent Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3263-7323","authenticated-orcid":false,"given":"Chimi","family":"Wangmo","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7543-1473","authenticated-orcid":false,"given":"Nima","family":"Dorji","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1460-9413","authenticated-orcid":false,"given":"Ugyen","family":"Rinzin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7994-6973","authenticated-orcid":false,"given":"Ugyen","family":"Chenzom","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0262-5456","authenticated-orcid":false,"given":"Tsheten","family":"Wangchuk","sequence":"additional","affiliation":[{"name":"Department of Surgery Regional Referral Hospital Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad332"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1402941"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens12040623"},{"key":"e_1_2_14_5_1","volume-title":"The Microbial Agents of Urinary Tract Infections at Central Laboratory of Dr","author":"Behzadi P.","year":"2008"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/ohbl.ohbl_56_24"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlab003"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/20499361251339383"},{"issue":"1","key":"e_1_2_14_9_1","article-title":"Antimicrobial Sensitivity Patterns of Bacteria Causing Urinary Tract Infections: A Retrospective Study of Elderly Patients Admitted to a Tertiary Care Hospital in Bhubaneswar, India","volume":"17","author":"Pathi B. K.","year":"2025","journal-title":"Cureus"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02287-24"},{"issue":"1","key":"e_1_2_14_11_1","article-title":"Antimicrobial Resistance among Uropathogens: Surveillance Report from South India","volume":"13","author":"Ravishankar U.","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-11588-w"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1183236"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1294869"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/life14010106"},{"key":"e_1_2_14_16_1","unstructured":"WHO Warns of Widespread Resistance to Common Antibiotics Worldwide cited2025October 19 2025 https:\/\/www.who.int\/news\/item\/13-10-2025-who-warns-of-widespread-resistance-to-common-antibiotics-worldwide."},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1135614"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijcm.ijcm_705_22"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2024.12.028"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinpr.2024.100359"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.5588\/pha.21.0035"},{"key":"e_1_2_14_22_1","unstructured":"National Statistics Bureau [Internet] December 31 2025 https:\/\/www.nsb.gov.bt\/."},{"key":"e_1_2_14_23_1","unstructured":"Ministry of Health MOH [Internet] (2011): 1\u201328 cited 2026 March 27 National Health Policy Ministry of Health https:\/\/moh.gov.bt\/wp-content\/uploads\/2025\/01\/National-Health-Policy.pdf."},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_2_14_25_1","unstructured":"World Health Organization Guidelines for the Prevention and Control of Carbapenem\u2010Resistant Enterobacteriaceae Acinetobacter baumannii and Pseudomonas aeruginosa in Health Care Facilities WHO World Health Organization 2017 cited 2026 October 5 2026 https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/5c6f2512-2f33-4e47-9b91-9edd1d780f01\/content."},{"key":"e_1_2_14_26_1","unstructured":"WHO World Health Organization [Internet] (2023) AWaRe Classification of Antibiotics for Evaluation and Monitoring of Use 2023 https:\/\/www.who.int\/publications\/i\/item\/WHO-MHP-HPS-EML-2023.04."},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1493980"},{"issue":"1","key":"e_1_2_14_28_1","article-title":"Epidemiological Study of the Antimicrobial Resistance Pattern of a Suspected Urinary Tract Infection in a Super Surgical, Super Specialty Hospital in Northern India","volume":"24","author":"Ahirwar N.","year":"2023","journal-title":"Medical Sciences Forum"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlae214"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idnow.2025.105123"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-026-13941-z"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-016-0910-2"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10040447"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1100\/2012\/349597"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.3126\/jonmc.v12i1.56340"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1099\/acmi.0.000321"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics13100925"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.53778\/pjkd82263"},{"issue":"3","key":"e_1_2_14_39_1","article-title":"Antimicrobial Resistance Trends in Urinary Tract Infection at Secondary Care Centres in Central India: Carbepenem Resistance Crossing 20% in Community","volume":"7","author":"Vyas A","year":"2023","journal-title":"Infectious Diseases Diagnosis & Treatment"},{"key":"e_1_2_14_40_1","unstructured":"Bhutan Food and Drug Authority \u2013 Royal Government of Bhutan [Internet] March 27 2026 https:\/\/bfda.gov.bt."},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0005022"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.5114\/pm.2021.105382"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.73364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:54:50Z","timestamp":1792403690000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.73364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":41,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/hsr2.73364"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.73364","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-03-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73364"}}