en Nephrology Nephrology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:13.9pt"><b><i><span style="color:blue">Background</span></i></b><i><span style="color:blue">:</span></i> Due to the increasing global prevalence of extended-spectrum beta-lactamase (ESBL)-producing uropathogenic strains, ongoing surveillance is required to monitor drug-resistant organisms causing urinary tract infections (UTIs) in kidney transplant recipients (KTRs). This study aimed to evaluate the antibiotic resistance profiles of uropathogenic isolates in KTRs with UTIs caused by ESBL-producing strains.</span><br> <span style="line-height:13.9pt"><b><i><span style="color:blue">Methods:</span></i></b> A total of 96 urine samples collected from KTRs were cultured on selective media and analyzed using phenotypic characterization and PCR methods. Antibiotic resistance patterns among uropathogenic isolates were evaluated using the disk diffusion and E-test methods. Data were analyzed using SPSS Version 21, and the level of significance was set at 0.05.</span><br> <span style="line-height:13.9pt"><b><i><span style="color:blue">Results:</span></i></b> Among the 26 uropathogenic isolates, uropathogenic <i>Escherichia coli</i> (UPEC) was the most prevalent (15, 57.7%), followed by <i>Klebsiella pneumoniae</i> (10, 38.5%) and <i>Enterococcus faecalis</i> (1, 3.8%). The rate of ESBL-producing isolates was 72% among UPEC and <i>K. pneumoniae</i> isolates. Antibiotic susceptibility testing revealed that ESBL-producing uropathogens exhibited significantly higher resistance rates (p < 0.05) than non-ESBL-producing strains to cefuroxime, cefepime, trimethoprim&ndash;sulfamethoxazole, ciprofloxacin, and levofloxacin. <i>E. faecalis</i> showed susceptibility to vancomycin, penicillin, and ampicillin and resistance to ciprofloxacin and levofloxacin.</span><br> <span style="line-height:13.9pt"><b><i><span style="color:blue">Conclusion</span></i></b><i><span style="color:blue">:</span></i> The rate of ESBL-related UTIs among KTRs was notable in this study. Based on the in vitro results, fosfomycin appears to be a promising oral therapeutic option for UTIs caused by ESBL-producing uropathogens in KTRs in the study region. In addition, the high prevalence of ESBL-producing isolates underscores the potential value of targeted prophylactic strategies for high-risk patients.</span></span></span><br> &nbsp; Urinary tract infections, Kidney Transplant Recipient, ESBLs, Uropathogen 613 621 http://caspjim.com/browse.php?a_code=A-10-3915-1&slc_lang=en&sid=1 Raheleh Sheikhi sheikhirahele@gmail.com 100319475328460057868 100319475328460057868 Yes Department of Microbiology, Virology and Microbial Toxins, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Mojgan Sigarchi sheikhi_r@yahoo.com 100319475328460057869 0009-0008-0157-335X No Department of Microbiology, Virology and Microbial Toxins, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Ali Monfared omidnaserii711@gmail.com 100319475328460057870 100319475328460057870 No Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Masoud Khosravi afshin0022003@yahoo.com 100319475328460057871 100319475328460057871 No Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Sara Darvishvand hashem_zare59@hotmail.com 100319475328460057872 0009-0004-7375-9664 No Department of Microbiology, Virology and Microbial Toxins, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Afagh Hassanzadeh Rad itnap.info@gmail.com 100319475328460057873 100319475328460057873 No Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran Elham Ramezanzade omidfeature@gmail.com 100319475328460057874 100319475328460057874 No Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Mohammad-kazem Lebadi sheikhi@gums.ac.ir 100319475328460057875 100319475328460057875 No Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Yalda Haghdar-Saheli zarehashem@sums.ac.ir 100319475328460057876 100319475328460057876 No Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Pegah Aghajanzadeh vcrdepinfo@sums.ac.ir 100319475328460057877 100319475328460057877 No Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Ali Movassaghi hashem.zare59@gmail.com 100319475328460057878 100319475328460057878 No Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran