A systematic review and meta-analysis of antibiotic resistance patterns, and the correlation between biofilm formation with virulence factors in uropathogenic E. coli isolated from urinary tract infections.

Urinary tract infection (UTI) is caused by the invasion of the pathogen in the urinary system that can manifest as symptomatic or asymptomatic bacteriuria. This study was conducted to investigate antibiotic resistance patterns, and the correlation between biofilm formations with virulence factors in uropathogenic E. coli isolates retrieved from UTI. We searched Scopus and Google Scholar, PubMed, Web of sciences for studies published in the English language between 1st 2005 to 31st December 2019. The Mesh terms and text words included "biofilms", OR "biofilm formation", AND "antibiotic resistance", OR "drug-resistance", OR "antimicrobial drug resistance", AND "urinary tract infections", OR "UTI", AND "biofilm related-genes", AND "virulence factors" AND "correlation", AND "Uropathogenic Escherichia coli", OR "Uropathogenic E. coli" AND "prevalence" AND "Iran". Data analyzed using Comprehensive Meta-Analysis (CMA) software. The random-effects model was used to calculate the pooled prevalence with 95% confidence interval (CI). The combined rates of biofilm formation in Uropathogenic E. coli (UPEC) isolates were achieved as 84.6% (95% CI: 72.7-91.9). Also, 24.8%, 26.1% and 44.6% of UPEC isolates were able to create strong, moderate and weak biofilm, respectively. The highest pooled antibiotic resistance was against Ampicillin followed by Tetracycline with resistance rates of 74.6% and 64.9%, respectively. Accordingly, some studies reported that biofilm production was significantly associated with antibiotic resistance and virulence genes (p < 0.05). This study showed a high tendency among UPEC isolates to form biofilm (more than 84%), also, most studies included in the present review reported a significant correlation between biofilm formation with antibiotic resistance and virulence factors.

Zhao F ，Yang H ，Bi D ，Khaledi A ，Qiao M ... -  《-》

Biofilm formation, antimicrobial susceptibility and virulence genes of Uropathogenic Escherichia coli isolated from clinical isolates in Uganda.

Katongole P ，Nalubega F ，Florence NC ，Asiimwe B ，Andia I ... -  《BMC INFECTIOUS DISEASES》

A global systematic review and meta-analysis on correlation between biofilm producers and non-biofilm producers with antibiotic resistance in Uropathogenic Escherichiacoli.

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.

Garousi M ，Monazami Tabar S ，Mirazi H ，Asgari P ，Sabeghi P ，Salehi A ，Khaledi A ，Ghenaat Pisheh Sanani M ，Mirzahosseini HK ... -  《-》

Distribution of genes encoding adhesins and biofilm formation capacity among Uropathogenic Escherichia coli isolates in relation to the antimicrobial resistance.

Escherichia coli is the most predominant pathogen involved in UTIs. Mainly, fimbrial surface appendages are implicated in adherence to urothelium besides non-fimbrial proteins. to determine prevalence of genes encoding fimbrial and non-fimbrial proteins among Uropathogenic Escherichia coli (UPEC). Furthermore, distribution of these genes and biofilm formation capacity were investigated in relation to antimicrobial resistance. Antimicrobial susceptibility of 112 UPEC isolates was performed using disc diffusion method. ESBL production was confirmed by double disc synergy test. Genes encoding fimbrial and non-fimbrial proteins were detected using PCR and biofilm formation was investigated using microtitre plate assay. UPEC isolates exhibited high resistance against doxycyclines (88.39 %), β-lactams (7.14-86.6%), sulphamethoxazole-trimethoprim (53.75%) and fluoro-quinolones (50%). Fifty percent of tested isolates were ESBL producers. PapGII gene was statistically more prevalent among pyelonephritis isolates. SfaS, focG and picU genes were statistically associated with fluoroquinolone (FQs) sensitive isolates and Dr/afaBC gene was statistically associated with ESBL production. Moreover, non-MDR isolates produced sturdier biofilm. PapGII adhesin variant seems to have a critical role in colonization of upper urinary tract. There is a possible link between antimicrobial resistance and virulence being capable of affecting the distribution of some genes besides its negative impact on biofilm formation.

Kadry AA ，Al-Kashef NM ，El-Ganiny AM 《-》

Association of antibiotic resistance and biofilm formation in Escherichia coli ST131/O25b.

Aydın E ，Kocaaga M ，Temel A 《-》