| Sumario: | Background: Patients with diabetes mellitus are at increased risk of urinary tract infections (UTIs) due to impaired immune function and metabolic changes, which may lead to serious complications and increased healthcare burdens. In the catchment area of Debre Tabor, northwest Ethiopia, data on UTI‐causing bacteria and their antimicrobial resistance profiles among diabetic patients remain limited. Given the rising threat of antimicrobial resistance, continuous local surveillance is essential for effective management and antibiotic stewardship. This study is aimed at determining the bacterial etiologies associated with UTIs, their resistance profiles, and associated factors among diabetic patients at Debre Tabor Comprehensive Specialized Hospital. Methods: A cross‐sectional study was conducted from May 15, 2022 to July 13, 2022 among 246 diabetic patients who were recruited using convenience sampling technique. Sociodemographic and clinical data were collected using a structured questionnaire. Midstream urine samples were collected for bacterial isolation, identification, and antimicrobial susceptibility testing using standard bacteriological methods. Data were entered and analyzed using SPSS Version 25 software. Descriptive statistics were used to summarize the data, and binary logistic regression was performed to identify factors associated with UTIs. A p value <0.05 with a 95% confidence interval was considered statistically significant. Results: In this study, the overall prevalence of significant bacteriuria was 35/246 (14.2%). Of the 35 isolates, the majority 29 (82.9%) were Gram‐negative bacteria. The predominant isolate was Escherichia coli at 18 (51.4%). Gram‐negative isolates were resistant to amoxicillin, trimethoprim/sulfamethoxazole, and cefotaxime at rates of 57.1%, 39.3%, and 35.7%. The proportion of antibiotic resistance among Gram‐positive bacteria ranged from 33.3% to 100%. Enterococcus species showed resistance to all tested antimicrobials. The overall multidrug resistance rate was 25.7%. Having symptoms of UTI (AOR: 9.57, 95% CI: 2.27–40.35) and being female (AOR: 2.63, 95% CI: 1.01–6.84) were significantly associated with significant bacteriuria. Conclusion: A considerable prevalence of significant bacteriuria was observed. Moreover, bacterial isolates demonstrated moderately high resistance to commonly used antimicrobials. Regular monitoring of antimicrobial resistance patterns and strengthening infection prevention strategies among diabetic patients in the study area are recommended.
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