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Alshaikh SA, El-Banna T, Sonbol F, Farghali MH. Correlation between antimicrobial resistance, biofilm formation, and virulence determinants in uropathogenic Escherichia coli from Egyptian hospital. Ann Clin Microbiol Antimicrob 2024; 23:20. [PMID: 38402146 PMCID: PMC10894499 DOI: 10.1186/s12941-024-00679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/11/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Uropathogenic Escherichia coli (UPEC) is the main etiological agent behind community-acquired and hospital-acquired urinary tract infections (UTIs), which are among the most prevalent human infections. The management of UPEC infections is becoming increasingly difficult owing to multi-drug resistance, biofilm formation, and the possession of an extensive virulence arsenal. This study aims to characterize UPEC isolates in Tanta, Egypt, with regard to their antimicrobial resistance, phylogenetic profile, biofilm formation, and virulence, as well as the potential associations among these factors. METHODS One hundred UPEC isolates were obtained from UTI patients in Tanta, Egypt. Antimicrobial susceptibility was assessed using the Kirby-Bauer method. Extended-spectrum β-lactamases (ESBLs) production was screened using the double disk synergy test and confirmed with PCR. Biofilm formation was evaluated using the microtiter-plate assay and microscopy-based techniques. The phylogenetic groups of the isolates were determined. The hemolytic activity, motility, siderophore production, and serum resistance of the isolates were also evaluated. The clonal relatedness of the isolates was assessed using ERIC-PCR. RESULTS Isolates displayed elevated resistance to cephalosporins (90-43%), sulfamethoxazole-trimethoprim (63%), and ciprofloxacin (53%). Ninety percent of the isolates were multidrug-resistant (MDR)/ extensively drug-resistant (XDR) and 67% produced ESBLs. Notably, there was an inverse correlation between biofilm formation and antimicrobial resistance, and 31%, 29%, 32%, and 8% of the isolates were strong, moderate, weak, and non-biofilm producers, respectively. Beta-hemolysis, motility, siderophore production, and serum resistance were detected in 64%, 84%, 65%, and 11% of the isolates, respectively. Siderophore production was correlated to resistance to multiple antibiotics, while hemolysis was more prevalent in susceptible isolates and associated with stronger biofilms. Phylogroups B2 and D predominated, with lower resistance and stronger biofilms in group B2. ERIC-PCR revealed considerable diversity among the isolates. CONCLUSION This research highlights the dissemination of resistance in UPEC in Tanta, Egypt. The evident correlation between biofilm and resistance suggests a resistance cost on bacterial cells; and that isolates with lower resistance may rely on biofilms to enhance their survival. This emphasizes the importance of considering biofilm formation ability during the treatment of UPEC infections to avoid therapeutic failure and/or infection recurrence.
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Affiliation(s)
- Sara A Alshaikh
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Tanta University, Tanta, 31511, Egypt.
| | - Tarek El-Banna
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Tanta University, Tanta, 31511, Egypt
| | - Fatma Sonbol
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Tanta University, Tanta, 31511, Egypt
| | - Mahmoud H Farghali
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Tanta University, Tanta, 31511, Egypt
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Saengsawang N, Ruang-Areerate P, Kaeothaisong N, Leelayoova S, Mungthin M, Juntanawiwat P, Hanyanunt P, Potisuwan P, Kesakomol P, Butsararattanagomen P, Wichaiwong P, Dungchai W, Ruang-Areerate T. Validation of quantitative loop-mediated isothermal amplification assay using a fluorescent distance-based paper device for detection of Escherichia coli in urine. Sci Rep 2023; 13:18781. [PMID: 37907677 PMCID: PMC10618465 DOI: 10.1038/s41598-023-46001-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/26/2023] [Indexed: 11/02/2023] Open
Abstract
Uropathogenic Escherichia coli (UPEC) causes up to 90% of urinary tract infections (UTI) which is more prevalent among females than males. In urine, patients with symptomatic UTI usually have a high concentration of bacterial infection, ≥ 105 colony-forming units (CFU) per mL, in which the culture method is regularly the gold standard diagnosis. In this study, a simple and inexpensive distance-based paper device (dPAD) combined with the fluorescent closed tube LAMP assay was validated for simultaneously screening and semi-quantifying the infection level of E. coli in 440 urine samples of patients with UTI. The dPAD could measure the LAMP amplicons and semi-quantify the levels of E. coli infection in heavy (≥ 104 CFU/mL), light (≤ 103 CFU/mL) and no infection. The sensitivity and specificity had reliable performances, achieving as high as 100 and 92.7%, respectively. The one step LAMP assay could be performed within 3 h, which was 7.5 times faster than the culture method. To empower early UTI diagnosis and fast treatment, this inexpensive dPAD tool combined with the fluorescent closed tube LAMP assay is simple, reliably fast and practically portable for point-of-care settings, particularly in resource-limited areas, which can be set up in all levels of healthcare facilities.
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Affiliation(s)
- Natkrittaya Saengsawang
- Analytical Chemistry, Department of Chemistry, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, 10140, Thailand
| | - Panthita Ruang-Areerate
- BIOTEC, National Science and Technology Development Agency (NSTDA), Pathum Thani, 12120, Thailand
| | - Nuanlaong Kaeothaisong
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Saovanee Leelayoova
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Piraporn Juntanawiwat
- Division of Microbiology, Department of Clinical Pathology, Phramongkutklao Hospital, Bangkok, 10400, Thailand
| | - Patomroek Hanyanunt
- Division of Microbiology, Department of Clinical Pathology, Phramongkutklao Hospital, Bangkok, 10400, Thailand
| | - Patsanun Potisuwan
- Division of Microbiology, Department of Clinical Pathology, Phramongkutklao Hospital, Bangkok, 10400, Thailand
| | - Piyanate Kesakomol
- Department of Microbiology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Pornphan Butsararattanagomen
- Analytical Chemistry, Department of Chemistry, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, 10140, Thailand
| | - Pattarawadee Wichaiwong
- Analytical Chemistry, Department of Chemistry, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, 10140, Thailand
| | - Wijitar Dungchai
- Analytical Chemistry, Department of Chemistry, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, 10140, Thailand.
| | - Toon Ruang-Areerate
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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Park I, Jailani A, Lee JH, Ahmed B, Lee J. The Antibiofilm Effects of Antimony Tin Oxide Nanoparticles against Polymicrobial Biofilms of Uropathogenic Escherichia coli and Staphylococcus aureus. Pharmaceutics 2023; 15:1679. [PMID: 37376127 DOI: 10.3390/pharmaceutics15061679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Biofilms are responsible for persistent or recurring microbial infections. Polymicrobial biofilms are prevalent in environmental and medical niches. Dual-species biofilms formed by Gram-negative uropathogenic Escherichia coli (UPEC) and Gram-positive Staphylococcus aureus are commonly found in urinary tract infection sites. Metal oxide nanoparticles (NPs) are widely studied for their antimicrobial and antibiofilm properties. We hypothesized that antimony-doped tin (IV) oxide (ATO) NPs, which contain a combination of antimony (Sb) and tin (Sn) oxides, are good antimicrobial candidates due to their large surface area. Thus, we investigated the antibiofilm and antivirulence properties of ATO NPs against single- and dual-species biofilms formed by UPEC and S. aureus. ATO NPs at 1 mg/mL significantly inhibited biofilm formation by UPEC, S. aureus, and dual-species biofilms and reduced their main virulence attributes, such as the cell surface hydrophobicity of UPEC and hemolysis of S. aureus and dual-species biofilms. Gene expression studies showed ATO NPs downregulated the hla gene in S. aureus, which is essential for hemolysin production and biofilm formation. Furthermore, toxicity assays with seed germination and Caenorhabditis elegans models confirmed the non-toxic nature of ATO NPs. These results suggest that ATO nanoparticles and their composites could be used to control persistent UPEC and S. aureus infections.
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Affiliation(s)
- Inji Park
- School of Chemical Engineering, Yeungnam University, 280 Daehak-ro, Gyeongsan 38541, Republic of Korea
| | - Afreen Jailani
- School of Chemical Engineering, Yeungnam University, 280 Daehak-ro, Gyeongsan 38541, Republic of Korea
| | - Jin-Hyung Lee
- School of Chemical Engineering, Yeungnam University, 280 Daehak-ro, Gyeongsan 38541, Republic of Korea
| | - Bilal Ahmed
- School of Chemical Engineering, Yeungnam University, 280 Daehak-ro, Gyeongsan 38541, Republic of Korea
| | - Jintae Lee
- School of Chemical Engineering, Yeungnam University, 280 Daehak-ro, Gyeongsan 38541, Republic of Korea
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Sadat A, Ramadan H, Elkady MA, Hammad AM, Soliman MM, Aboelenin SM, Al-Harthi HF, Abugomaa A, Elbadawy M, Awad A. Phylotypic Profiling, Distribution of Pathogenicity Island Markers, and Antimicrobial Susceptibility of Escherichia coli Isolated from Retail Chicken Meat and Humans. Antibiotics (Basel) 2022; 11:antibiotics11091197. [PMID: 36139976 PMCID: PMC9495032 DOI: 10.3390/antibiotics11091197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/20/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
Escherichia coli (E.coli) found in retail chicken meat could be causing a wide range of infections in humans and constitute a potential risk. This study aimed to evaluate 60 E. coli isolates from retail chicken meat (n = 34) and human urinary tract infections (UTIs, n = 26) for phylogenetic diversity, presence of pathogenicity island (PAI) markers, antimicrobial susceptibility phenotypes, and antimicrobial resistance genes, and to evaluate their biofilm formation capacity. In that context, confirmed E.coli isolates were subjected to phylogrouping analysis using triplex PCR, antimicrobial susceptibility testing using the Kirby–Bauer disc diffusion method; PAI distribution was investigated by using two multiplex PCRs. Most of the chicken isolates (22/34, 64.7%) were identified as commensal E. coli (A and B1), while 12 isolates (35.3%) were classified as pathogenic virulent E. coli (B2 and D). Similarly, the commensal group dominated in human isolates. Overall, 23 PAIs were detected in the chicken isolates; among them, 39.1% (9/23) were assigned to group B1, 34.8% (8/23) to group A, 4.34% (1/23) to group B2, and 21.7% (5/23) to group D. However, 25 PAIs were identified from the human isolates. PAI IV536 was the most prevalent (55.9%, 69.2%) PAI detected in both sources. In total, 37 (61.7%) isolates of the chicken and human isolates were biofilm producers. Noticeably, 100% of E. coli isolates were resistant to penicillin and rifamycin. Markedly, all E. coli isolates displayed multiple antibiotic resistance (MAR) phenotypes, and the multiple antibiotic resistance index (MARI) among E. coli isolates ranged between 0.5 and 1. Several antibiotic resistance genes (ARGs) were identified by a PCR assay; the sul2 gene was the most prevalent (38/60, 63.3%) from both sources. Interestingly, a significant positive association (r = 0.31) between biofilm production and resistance to quinolones by the qnr gene was found by the correlation analysis. These findings were suggestive of the transmission of PAI markers and antibiotic resistance genes from poultry to humans or humans to humans through the food chain. To avoid the spread of virulent and multidrug-resistant E. coli, intensive surveillance of retail chicken meat markets is required.
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Affiliation(s)
- Asmaa Sadat
- Department of Bacteriology, Mycology, and Immunology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Hazem Ramadan
- Hygiene and Zoonoses Department, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed A. Elkady
- Mansoura Veterinary Laboratory Branch, Microbiology Research Department, Animal Health Research Institute, Kafrelsheikh 33516, Egypt
| | - Amal Mahmoud Hammad
- Biochemistry Department, Faculty of Medicine Damietta, Al-Azhar University, Cairo 11651, Egypt
| | - Mohamed M. Soliman
- Clinical Laboratory Sciences Department, Turabah University College, Taif University, Taif 21995, Saudi Arabia
| | - Salama M. Aboelenin
- Biology Department, Turabah University College, Taif University, Al Hawiyah 21995, Saudi Arabia
| | - Helal F. Al-Harthi
- Biology Department, Turabah University College, Taif University, Al Hawiyah 21995, Saudi Arabia
| | - Amira Abugomaa
- Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed Elbadawy
- Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh 13736, Egypt
| | - Amal Awad
- Department of Bacteriology, Mycology, and Immunology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
- Correspondence: ; Tel.: +2-0102-127-6993
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Phylogenetic groups and antimicrobial resistance characteristics of Escherichia coli strains isolated from clinical samples in North Iran. Arab J Gastroenterol 2022; 23:102-107. [PMID: 35473686 DOI: 10.1016/j.ajg.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/30/2021] [Accepted: 02/07/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND STUDY AIM Extraintestinal pathogenic Escherichia coli (ExPEC) is one of the most common bacterial pathogens, which causes a remarkable amount of morbidity and mortality. This study was designed to determine the antibiotic resistance profiles, phylogenetic groups, and subgroup analyses among the ExPEC strains isolated from hospitalized patients in north Iran. PATIENTS AND METHODS This cross-sectional investigation was conducted at five educational hospitals in Rasht in north Iran. Using standard microbiological tests, 150 E. coli isolates were identified. The antibiotic susceptibility pattern of all isolates was determined using the disk diffusion method. The double disk phenotypic confirmatory test was performed to detect extended-spectrum β-lactamase (ESBL)-producing isolates. A triplex polymerase chain reaction (PCR) was performed to determine the phylogenetic group of each strain. RESULTS The results of antibiogram pattern showed that E. coli isolates were mostly non-susceptible to ampicillin (79.3%), followed by nalidixic acid (75.3%) and cephalothin (70%), whereas nitrofurantoin (94.7%) was the most effective agent, followed by imipenem (92.7%). The rate of ESBL-producing isolates was 53.3% (80/150). Multiplex PCR screening revealed that the most common phylogroup was the B2 group (97 isolates; 64.6%), followed by the D group (34, 22.7%). In contrast, phylogroup analyses showed that B23 (50.7%) and D2 (16.4%) were the most common subgroups. CONCLUSIONS Our findings indicated a considerable rate of antibiotic resistance and ESBL-producing isolates among E. coli strains isolated from clinical samples. Moreover, we reported a tendency that most isolates belonged to the B2 and D phylogroups. As a result, the detection of genotypic identical or similar isolates indicated that these isolates have an endurance capability in the hospital environment and could be transmitted among patients.
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A global systematic review and meta-analysis on correlation between Biofilm producers and Non-biofilm producers with antibiotic resistance in Uropathogenic Escherichiacoli. Microb Pathog 2022; 164:105412. [PMID: 35065252 DOI: 10.1016/j.micpath.2022.105412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 01/26/2023]
Abstract
Escherichia coli accounts for nearly 80% of community-acquired and 50% of hospital-acquired urinary tract infections (UTI). This study aimed to evaluate the correlation between biofilm producers and Non-biofilm producers with antibiotic resistance in Uropathogenic Escherichia coli (UPEC) isolated from patients with UTI globally. The search was conducted between 1st 2000 to 30th October 2021 in various databases (PubMed, Scopus, Web of sciences, and Google Scholar) with suitable MeSH terms, and text words. Then, after applying the appropriate inclusion and exclusion criteria on the studies for their selection, the data were analyzed by CMA software. Thirty-seven studies met the eligibility criteria to include. The pooled prevalence of ESBL and MDR isolates were reported 37.9%, and 65.8%, respectively. Biofilm formation varied between 13.3% and 99% all over the world. A total of 74.4% of all isolates were biofilm producers, out of which 28.6%, 35.2%, and 38.6% showed strong, moderate, and weak biofilm. The highest and lowest resistance was against Amoxicillin and Meropenem with the prevalence of 80.8%, and 13%, respectively. Fourteen out of 17(82.35%) studies reported a positive correlation between biofilm and antibiotic resistance. Findings showed high numbers of isolates were able to form biofilm, which is one of the factors of antibiotic resistance, and this has been confirmed by the positive significant correlation between biofilm formation and antibiotic resistance that has been reported by studies included. Therefore, due to the importance of biofilm in the etiology of UTI caused by UPEC, it should be prevented; consequently, bacterial resistance can be reduced and controlled.
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Gajdács M, Kárpáti K, Nagy ÁL, Gugolya M, Stájer A, Burián K. Association between biofilm-production and antibiotic resistance in Escherichia coli isolates: A laboratory-based case study and a literature review. Acta Microbiol Immunol Hung 2021. [PMID: 34524972 DOI: 10.1556/030.2021.01487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022]
Abstract
Bacteria can enhance their survival by attaching to inanimate surfaces or tissues, and presenting as multicellular communities encased in a protective extracellular matrix called biofilm. There has been pronounced interest in assessing the relationship between the antibiotic resistant phenotype and biofilm-production in clinically-relevant pathogens. The aim of the present paper was to provide additional experimental results on the topic, testing the biofilm-forming capacity of Escherichia coli isolates using in vitro methods in the context of their antibiotic resistance in the form of a laboratory case study, in addition to provide a comprehensive review of the subject. In our case study, a total of two hundred and fifty (n = 250) E. coli isolates, originating from either clean-catch urine samples (n = 125) or invasive samples (n = 125) were included. The colony morphology of isolates were recorded after 24h, while antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Biofilm-formation of the isolates was assessed with the crystal violet tube-adherence method. Altogether 57 isolates (22.8%) isolates were multidrug resistant (MDR), 89 isolates (35.6%) produced large colonies (>3 mm), mucoid variant colonies were produced in 131 cases (52.4%), and 108 (43.2%) were positive for biofilm formation. Biofilm-producers were less common among isolates resistant to third-generation cephalosporins and trimethoprim-sulfamethoxazole (P = 0.043 and P = 0.023, respectively). Biofilms facilitate a protective growth strategy in bacteria, ensuring safety against environmental stressors, components of the immune system and noxious chemical agents. Being an integral part of bacterial physiology, biofilm-formation is interdependent with the expression of other virulence factors (especially adhesins) and quorum sensing signal molecules. More research is required to allow for the full understanding of the interplay between the MDR phenotype and biofilm-production, which will facilitate the development of novel therapeutic strategies.
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Affiliation(s)
- Márió Gajdács
- 1Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza Lajos krt 63., 6720 Szeged, Hungary
- 2Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4., 1089 Budapest, Hungary
| | - Krisztina Kárpáti
- 3Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 64-66., 6720 Szeged, Hungary
| | - Ádám László Nagy
- 4Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64., 6720 Szeged, Hungary
| | - Máté Gugolya
- 2Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4., 1089 Budapest, Hungary
| | - Anette Stájer
- 5Department of Periodontology, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64., 6720 Szeged, Hungary
| | - Katalin Burián
- 6Department of Medical Microbiology, Albert Szent-Györgyi Health Center and Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725 Szeged, Hungary
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