{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:15:50Z","timestamp":1786119350003,"version":"build-2736575974"},"reference-count":0,"publisher":"Journal of Infection in Developing Countries","issue":"07","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Infect Dev Ctries"],"abstract":"<jats:p>Introduction: Urinary tract infections (UTIs) are a leading cause of antibiotic use globally, with rising antimicrobial resistance (AMR) complicating management\u2014particularly in healthcare settings.\nMethodology: This cross-sectional study compared community-acquired (CA-UTI) and healthcare-associated UTIs (HA-UTI) at the Habib Thameur Hospital\u2019s emergency\u2013intensive care unit in Tunis during 2022\u20132023.\nResults: Out of a total of 4,474 urine samples, 446 (10%) were culture-positive. The patients were predominantly elderly (73.3% were \u2265 60 years). More females had CA-UTI (M:F = 0.57) than HA-UTI (M:F = 0.78). Escherichia coli was the main pathogen causing both CA-UTI (57.4%) and HA-UTI (44.6%), while Klebsiella pneumoniae was the more common pathogen in HA-UTI (26.1% vs. 23.3%). Gram-negative bacteria accounted for 90.6% of isolates. Among the K. pneumoniae isolates, resistance to imipenem was significantly higher among HA-UTI isolates (29.2% vs. 5.9%; p = 0.02). Among the E. coli isolates, resistance to nitrofurantoin was significantly higher among HA-UTI isolates (3.7% vs. 12.5%; p = 0.01). Extended-spectrum \u03b2-lactamase (ESBL)-producing Enterobacteriaceae were detected in 8.5% of isolates (mostly E. coli and K. pneumoniae), and carbapenem-resistant Enterobacteriaceae (CRE) in 8.7% (predominantly K. pneumoniae in HA-UTI). CRE showed near-complete \u03b2-lactam resistance and high non-\u03b2-lactam resistance in HA-UTI.\nConclusions: Rising UTI rates and alarming AMR trends, particularly in HA-UTIs, highlight the need for enhanced antibiotic stewardship and tailored empirical therapy. The predominance of multidrug-resistant strains underscores the urgency for infection control measures in Tunisian healthcare settings.<\/jats:p>","DOI":"10.3855\/jidc.21837","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T17:57:49Z","timestamp":1786039069000},"page":"990-996","source":"Crossref","is-referenced-by-count":0,"title":["Community and healthcare-associated UTIs: antimicrobial resistance patterns in a Tunisian emergency-intensive care unit"],"prefix":"10.3855","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1917-5181","authenticated-orcid":false,"given":"Manel","family":"Ennaceur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofien","family":"Bouzazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Chouaieb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2222","published-online":{"date-parts":[[2026,7,31]]},"container-title":["The Journal of Infection in Developing Countries"],"original-title":[],"link":[{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/21837\/3921","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/21837\/3921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T17:57:49Z","timestamp":1786039069000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/view\/21837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":0,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2026,7,31]]}},"URL":"https:\/\/doi.org\/10.3855\/jidc.21837","relation":{},"ISSN":["1972-2680"],"issn-type":[{"value":"1972-2680","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}