Introduction. Antimicrobial resistance is a global public health problem that can lead to treatment failure, increased mortality and morbidity associated with urinary tract infections. Objective. To evaluate the results of urine cultures collected at T. Mosneaga Clinical Hospital, with a focus on identifying the evolution of microbial spectrum and antibiotic resistance. Material and methods. A retrospective study was conducted involving analysis of urine culture results collected from hospitalized patients between 2018-2021. A total of 22,076 urine cultures were included. Urine cultures were collected within the first 48 hours of hospitalization. Results. Out of the total of 22,076 urine samples, 5,500 were positive for pathogens (24.9%). Gram-negative microorganisms (Enterobacteriaceae - 60%) were the most commonly identified, with a decreasing incidence over the years, followed by Klebsiella pneumonia (20%) and Pseudomonas aeruginosa (10%), the latter showing an increasing incidence. Sensitivity was higher (85%) for antibiotics from the aminoglycoside group (amikacin), while preparations from the fluoroquinolone group (ciprofloxacin) showed lower sensitivity (37%). Conclusion. It has been demonstrated that over the reference years, the evolution of the microbial spectrum was characterized by an increasing incidence of Klebsiella P. and Pseudomonas A., with a corresponding decrease in the incidence of Enterobacteriaceae. The identified agents showed increased sensitivity to aminoglycosides and significant antibacterial resistance to fluoroquinolones. The most spectacular evolution was recorded during the Covid-19 pandemic (2019-2020).