Biofilm Forming Capability, Multidrug Resistance and Detection of Associated Genes in Uropathogenic Escherichia coli isolated from Catheterized Patients

Urinary tract infection (UTI) is one of the most widely recognized bacterial infections worldwide. Uropathogenic Escherichia coli (UPEC) is one of the main causative agents for nosocomial UTI. The microbial biofilms cause a public health problem to persons who require indwelling medical devices such as a urinary catheter. The pathogens in biofilms are protected from unfavorable conditions, antibiotic therapies and the host's immune system. The aim of the present study was to detect biofilm producer isolates, find out the correlation between biofilm production and associated virulence genes, and determination of antimicrobial susceptibility pattern of E. coli isolates isolated from the catheterized patient. In this study, we examined 43 isolates of E. coli collected from catheterized patients at three hospitals inside Erbil city during 25 of March to 23 of July 2018. All isolates were 100% biofilm producers using 96-well flat bottomed microtiter plate method. Also, molecular detection of uspA gene was performed as a species-specific PCR based marker for molecular identification of E. coli. fimH and papC genes were detected in 100% and 79% of the isolates respectively, as two adhesion genes responsible for biofilm formation. Minimal inhibitory concentrations (MIC50 and MIC90) were defined as the lowest concentration of antimicrobials which show 50% and 90% inhibition of planktonic form and (BIC50, BIC90) were biofilm inhibitory concentration. All isolates were 100% resistant for Ceftriaxone, Ciprofloxacin, Levofloxacin and Cotrimoxazole. While the most effective antimicrobial agent used in the current study was Nitrofurantoin. Furthermore, most of isolates in the biofilm form were more resistant to antimicrobial agents than those of the planktonic form. Additionally, there was a positive relationship between the adhesion genes and the capacity to produce biofilm in UPEC.