Epidemiological Profile of Tuberculosis Patients in Kazakhstan: A Synthesis of National Surveillance Data

Abstract

Background. Urinary tract infections (UTIs) are among the most common bacterial infections worldwide and disproportionately affect women across the life course. Rising antimicrobial resistance in key uropathogens—chiefly Escherichia coli—threatens the effectiveness of standard empirical therapy, making local and regional epidemiological data essential for rational management.

Objective. To synthesise the epidemiological patterns of UTIs in women—burden, risk factors, causative organisms, and antimicrobial-resistance profiles—with particular attention to evidence from Kazakhstan and the surrounding region, set within the wider international literature.

Methods. We conducted a structured synthesis of published evidence, prioritising large narrative reviews, multicentre surveillance studies (notably the DARMIS-2018 study spanning Russia, Belarus, and Kazakhstan), and regional cohort analyses, supplemented by international epidemiological data.

Results. Approximately 40–60% of adult women experience at least one UTI in their lifetime, of whom 30–44% experience recurrence; annual incidence of physician-diagnosed UTI in women exceeds 10%, and prevalence in women over 65 is roughly double the overall female rate. E. coli predominates, causing around 75–90% of uncomplicated community-acquired UTIs. In the regional DARMIS-2018 surveillance, Enterobacterales comprised about 89% of isolates and E. coli about 69% among adults, with fosfomycin and nitrofurantoin retaining the highest activity. Resistance to older first-line agents (ampicillin, co-trimoxazole, fluoroquinolones) is high and rising.

Conclusion. UTIs impose a large, gendered burden on women, compounded by escalating antimicrobial resistance. Regional surveillance from Kazakhstan and neighbouring countries supports nitrofurantoin and fosfomycin as preferred empirical agents for uncomplicated infection and underscores the need for continued local resistance monitoring and antimicrobial stewardship.