Introduction: This study analyzes urinary tract infections (UTIs) in a hospital in Central Portugal over a five-year period, focusing on bacterial prevalence, patient demographics, and antibiotic resistance patterns. This investigation aims to provide insights that can guide improved infection control and treatment strategies. Methods: A total of 6161 positive urine cultures collected over five years were examined, with particular emphasis on 2019 due to a peak in infection rates. The analysis explored bacterial prevalence, demographic factors such as sex and clinical service origin, and antibiotic resistance. Special attention was given to hospitalized patients, especially those undergoing invasive procedures, due to their increased vulnerability to infection. Results: This study found that UTIs were more prevalent in female patients, reflecting anatomical susceptibilities. Hospitalized individuals, particularly those requiring invasive procedures, were at greater risk. The predominant bacteria were Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis, with differences in prevalence by patient sex and service origin. Resistance to Imipenem in E. coli increased, raising concerns about last-resort treatments. However, resistance to other antibiotics declined, suggesting improvements due to recent stewardship measures. During the COVID-19 pandemic, overall antibiotic consumption decreased due to changes in clinical practices. Conclusion: The findings highlight the importance of strict infection control, targeted prevention measures, and rational antibiotic use to combat resistance. Ongoing surveillance and personalized treatment approaches are essential to improve UTI management and outcomes.

This study explores the prevalence and antibiotic resistance of urinary tract infections (UTIs) in pregnant women in central Portugal. A retrospective observational study was conducted on 201 positive urine cultures from pregnant women at a hospital center between January 2018 and December 2022. The data collected included age, hospital admission source, history of antibiotic therapy, catheterization status, identity of bacterial isolates, and their antibiotic profile. The most common bacterial strains were Escherichia coli (52.4%) and Streptococcus agalactiae (16.9%). In terms of antibiotic resistance, Escherichia coli demonstrated complete sensitivity to ertapenem, while Streptococcus agalactiae showed sensitivity to four antibiotics, including trimethoprim/sulfamethoxazole. Notably, most infections occurred in the third trimester, underscoring the need for continuous monitoring throughout pregnancy. This study emphasizes the importance of tailored treatment strategies to manage UTIs in pregnancy effectively, reducing the potential maternal and fetal complications. These findings contribute to regional data on UTI management in pregnant populations and aim to support improved healthcare practices. These regional data provide a solid foundation for optimizing healthcare practices in pregnant women, suggesting targeted approaches to combat antibiotic resistance and improve maternal–fetal safety during UTI treatment.

Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide and represent a significant public health concern due to their high prevalence and increasing antimicrobial resistance. This study aimed to systematically review the epidemiology, uropathogens, and resistance patterns of UTIs in Portugal over the last decade. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. A literature search was performed in April 2026. A total of 425 records were identified. After removal of duplicates and preliminary exclusions, 121 records were screened by title and Following application of eligibility criteria, 41 full-text articles were assessed, of which 13 met the criteria for detailed eligibility assessment. Six studies met the inclusion criteria and were included in the final qualitative synthesis. Results: The included studies consistently reported a higher prevalence of UTIs in females and, in some cases, in older populations. Escherichia coli was identified as the predominant uropathogen across all studies, followed by Klebsiella pneumoniae, Proteus spp., and Enterococcus spp. A consistently high prevalence of antimicrobial resistance was observed, particularly against commonly used antibiotics such as ampicillin and trimethoprim–sulfamethoxazole. The presence of extended-spectrum β-lactamase (ESBL)-producing strains was also reported, especially in healthcare-associated infections, which exhibited higher resistance profiles compared to community-acquired infections. Conclusions: The available evidence suggests that UTIs in Portugal are predominantly caused by enterobacteria, particularly Escherichia coli. However, the limited number and heterogeneity of studies highlight the need for cautious interpretation. Further multicenter and methodologically robust studies are required to better characterize national epidemiological patterns and antimicrobial resistance trends.