Tarbiat Modares University Infection Epidemiology and Microbiology 2588-4107 12 2 2026 09 01 Community Circulation of Multidrug-Resistant Escherichia coli Associated with Urinary Tract Infections 109 120 29039 10.52547/iem.12.2.109 EN Patrícia Guedes Garcia Department of Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Juiz de Fora, Brazil Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil 0000-0002-0795-6422 Bianca Silva Soares Department of Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Juiz de Fora, Brazil. Janita Soraia De Oliveira Da Silva Department of Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Juiz de Fora, Brazil. Luzia Miranda Da Silva Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Luciana Debortoli De Carvalho Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Marcio Roberto Silva Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Embrapa Dairy Cattle, Brazilian Agricultural Research Company, Juiz de Fora, Minas Gerais, Brazil Marcelo Silva Silvério Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil Natalia Maria Da Silva Fernandes Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. 0000-0001-8728-7937 Journal Article 2026 02 26 <strong>Background: </strong>This study aimed to investigate the antimicrobial resistance profile and the occurrence of multidrug resistance (MDR) among Escherichia coli isolates recovered from urine cultures of outpatients attending a public teaching hospital in Brazil and to assess the association of sex and age with MDR.<br><strong>Materials & Methods:</strong> This cross-sectional study was conducted based on a retrospective analysis of urine cultures collected from outpatients between January and December 2024. Descriptive statistics were applied, and univariate and multivari<br>ate logistic regression analyses were performed to identify factors associated with MDR.<br><strong>Findings:</strong> Among 1955 urine cultures analyzed, 418 (21.4%) demonstrated significant bacterial growth, with E. coli accounting for 48.3% (n=202) of the positive cultures. The highest resistance rates were to ampicillin (56.9%), ciprofloxacin (37.6%), and trimethoprim–sulfamethoxazole (35.0%), whereas the lowest resistance rates were observed to nitrofurantoin (8.3%) and fosfomycin (3.1%). MDR was identified in 71 (35.1%) E. coli isolates, among which 24 (33.8%) exhibited an extended-spectrum β-lactamase phenotype, and three (4.2%) produced carbapenemases. In the multivariate analysis, above-median age was independently associated with MDR (adjusted OR = 2.27; 95% CI: 1.24–4.14)<br><strong>Conclusion:</strong> A substantial proportion of E. coli isolates from community-acquired urinary tract infections presented multidrug resistance, particularly among older patients. These findings emphasize the importance of local surveillance of antimicrobial resistance and periodic review of empirical treatment protocols in outpatient settings. https://iem.modares.ac.ir/article_29039_9301cb784fa8d1f29d1125c71184ab94.pdf