Abstract
Urinary tract infections (UTIs) are among the most common infections requiring medical attention worldwide. The production of biofilms is an important step in UTIs, not only from a mechanistic point of view, but this may also confer additional resistance, distinct from other aspects of multidrug resistance (MDR). A total of two hundred and fifty (n = 250) Escherichia coli isolates, originating from clean-catch urine samples, were included in this study. The isolates were classified into five groups: wild-type, ciprofloxacin-resistant, fosfomycin-resistant, trimethoprim-sulfamethoxazole-resistant and extended spectrum β-lactamase (ESBL)-producing strains. The bacterial specimens were cultured using eosine methylene blue agar and the colony morphology of isolates were recorded. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method and E-tests. Biofilm-formation of the isolates was carried out with the crystal violet tube-adherence method. n = 76 isolates (30.4%) produced large colonies (>3 mm), mucoid variant colonies were produced in n = 135 cases (54.0%), and n = 119 (47.6%) were positive for biofilm formation. The agreement (i.e., predictive value) of mucoid variant colonies in regard to biofilm production in the tube-adherence assay was 0.881 overall. Significant variation was seen in the case of the group of ESBL-producers in the ratio of biofilm-producing isolates. The relationship between biofilm-production and other resistance determinants has been extensively studied. However, no definite conclusion can be reached from the currently available data.
Highlights
The global burden of diseases has shown considerable changes in the last century
Urinary tract infections (UTIs) are some of the most common illnesses caused by pathogenic microorganisms, predominantly by facultative Gram-negative bacteria [2,3,4]; the most common causative agents of urinary tract infections (UTIs) are the members of the Enterobacterales
The principal cause of UTIs (>90%) are uropathogenic Escherichia coli (UPEC) and uropathogenic Klebsiella pneumoniae (UPKP), while other members of the order are represented to a lesser extent [7,8]
Summary
Despite global trends due to demographic and epidemiological transitions, and the more pronounced role of non-communicable illnesses, infectious pathologies are still an important factor for morbidity and mortality [1] Among these infectious diseases, urinary tract infections (UTIs) are some of the most common illnesses caused by pathogenic microorganisms, predominantly by facultative Gram-negative bacteria [2,3,4]; the most common causative agents of UTIs are the members of the Enterobacterales. The principal cause of UTIs (>90%) are uropathogenic Escherichia coli (UPEC) and uropathogenic Klebsiella pneumoniae (UPKP), while other members of the order are represented to a lesser extent [7,8] These infections account for 10–30% of infections in community settings and 25–60% of nosocomial infections overall (predominantly due to catheter-associated infections), representing a serious economic and public health issue for healthcare infrastructures [9,10]. The subsequent costs of UTIs for national economies (including losses due to sick leave, hospital admissions and pharmacotherapy) may be pronounced, estimated to be as high as USD 6 billion [13]
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