Biofilm Mediated Antibiotic Resistance in Uropathogenic Escherichia Coli Isolated From Egyptian Women with Urinary Tract Infections

Background: Urinary tract infection (UTI) is a pathogenic invasion of the urothelium with resultant inflammation, encompassing a spectrum of upper and lower urinary tract disease. Biofilms provide a survival strategy to the bacteria by positioning them to effectively use the available nutrients and prevent access to antimicrobial agents, antibodies and white blood cells. Objective: This study aims to describe the profile of biofilm forming bacteria e.g. E.coli from Egyptian women with UTIs, determine the antimicrobial susceptibility patterns of isolated pathogens, Evaluate the genes responsible for biofilm formation and investigate the biofilm formation and its role in antibiotic resistance. Methodology: The study was conducted on female patients admitted to Naga Hammadi General Hospital from January 2022 to January 2023.Two hundred and fifty urine samples were collected from female patients. Viable count conducted on urine sample by calibrated loop technique. If the number of colonies in freshly voided urine samples is ≥ 105 CFU/mL, this has been usually registered as UTI. The UPEC were isolated by cultivation different culture media (MacConkey and EMB), and confirmed by biochemical confirmatory tests, TSI, Citrate and indole test. Results: the total studied cases were 250 participants, only 51 cases were positive for E. coli (20.4%). All the patients were female patients. Their ages varied between 16 years and 60 years including 13 single female, 38 married. The UTI rate was higher among married female patients (74.5%). Escherichia coli was the most frequent isolated bacteria 51 isolates (20.4%). All uropathogenic E.coli in this study were tested for the presence of RcsA; 46 positive for FocA, 19 positive for CsgA, 22 positive for CsgD and 13 positive for RcsC gene. Conclusion: Our study revealed that Uropathogenic E. coli (UPEC) is the most predominant causative agent of urinary tract infections. Fosfomycin is the drug of choice for treatment of Urinary tract infections (UTI) caused by UPEC. It showed a low incidence of bacterial resistance as it is taken as a single dose unit.