en Clinical Biochemistry Clinical Biochemistry پژوهشي Research <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Introduction</b>: In fact, individuals with diabetes mellitus (DM) are highly susceptible to developing urinary tract infections (UTIs). This study aimed to evaluate the etiologic agents of UTIs and their patterns of antimicrobial resistance among diabetic patients with UTIs in Ilam, western Iran.</span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Materials & Methods</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: </span></span></b>A cross-sectional study was conducted from June 2020 to December 2023 in Ilam, in western Iran. A total of 3,362 patients with DM and UTI were evaluated for common uropathogens. Bacterial identification was performed using colony morphology, Gram staining, and standard biochemical tests. The antibiotic susceptibility pattern was determined using the Kirby-Bauer disk diffusion method on Muller-Hinton agar. Data analysis was performed using SPSS software version 16.0. Fisher&#39;s exact test and Pearson&#39;s chi-square test were used to assess the association between the variables (<i>p</i>-value <0.05 as significant).<span lang="FA" dir="RTL" style="font-family:"Times New Roman","serif""></span></span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Results</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: &nbsp;</span></span></b>Among the diabetic samples, 0.8% (27/3,362) were positive for uropathogens, with a higher prevalence in females (77.8%) than in males (22.2%) (<i>p</i>-value = 0.03). All positive cases were older than 44 years (<i>p</i>-value = 0.02). Gram-negative bacteria (GNB) were more common (70.3%) than gram-positive bacteria (GPB) (29.7%) (<i>p</i>-value = 0.001). <i>Escherichia coli</i> was the predominant pathogen (63%), followed by coagulase-negative <i>staphylococci</i> (25.9%), <i>Citrobacter</i> spp. (3.7%), <i>Klebsiella</i> spp. (3.7%), and coagulase-positive <i>staphylococci</i> (3.7%). Cefazolin and cephalexin showed the highest efficacy against GNB (both 10.5% resistance), whereas norfloxacin (63.2%), ampicillin (57.9%), and nalidixic acid (52.6%) exhibited higher resistance rates. Among GPB, co-trimoxazole, gentamycin, cefazolin, and amoxicillin/clavulanic acid were more effective (100% sensitive), whereas oxacillin (37.5%) showed poor efficacy.</span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Conclusion</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: &nbsp;</span></span></b>This study highlights the prevalence and resistance patterns of uropathogens in diabetic patients with UTIs, emphasizing the need for targeted antibiotic therapy and continuous monitoring.</span></span><br> <br> <br> &nbsp; Urinary Tract Infections, Drug Resistance, Diabetes 1 9 http://jbrms.medilam.ac.ir/browse.php?a_code=A-10-788-3&slc_lang=en&sid=1 Saeed Hemati saeedhemati0064@gmail.com 10031947532846008265 10031947532846008265 No Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Maryam Kheiry m.kheri@yahoo.com 10031947532846008266 10031947532846008266 No Non-Communicable Diseases Research Center, Ilam University of Medical sciences, Ilam, Iran Farajolah Maleki Fmaleki531@gmail.com 10031947532846008267 10031947532846008267 Yes Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of medical Sciences, Ilam, Iran