Investigation of biofilm production and antibiotic susceptibility in Escherichia coli isolated from urinary tract infections

Sumayya Sabah Hussien; Mohammed Yawoz Noraldeen; Abdullah Adil Raoof

doi:10.56286/44mks696

Authors

Sumayya Sabah Hussien Department of Medical Laboratory Techniques, College of Health and Medical Techniques, Northern Technical University, Kirkuk 36001, Iraq
Mohammed Yawoz Noraldeen Department of Medical Laboratory Techniques, College of Health and Medical Techniques, Northern Technical University, Kirkuk 36001, Iraq https://orcid.org/0000-0001-8718-4364
Abdullah Adil Raoof Department of Medicine, Kirkuk Medical College, University of Kirkuk, 36001 Kirkuk, Iraq https://orcid.org/0000-0001-5294-9830

DOI:

https://doi.org/10.56286/44mks696

Keywords:

E. coli, UTI, Biofilm, Antibiotic, Susceptibility

Abstract

Urinary tract infections (UTIs) are among the most common bacterial infections affecting individuals of all age groups and represent a significant public health concern worldwide. They are responsible for a substantial number of hospital admissions and outpatient visits and are frequently associated with recurrent infections, prolonged treatment, and the emergence of multidrug-resistant bacterial pathogens. The increasing prevalence of antimicrobial resistance among uropathogens has complicated the empirical management of UTIs, highlighting the need for continuous surveillance of bacterial isolates and their antimicrobial susceptibility patterns. Therefore, the present study aimed to identify the most common bacterial pathogens causing urinary tract infections and to evaluate the antibiotic sensitivity and resistance profiles of the isolated bacteria. A total of 160 clinical urine samples were collected from patients with suspected UTIs who attended Kirkuk Hospital, Kirkuk City, Iraq, between October 2023 and February 2024. Samples were obtained from hospitalized and outpatient individuals following examination by specialist physicians and referral to the microbiology laboratory. Standard microbiological procedures were used for bacterial isolation and identification, followed by antimicrobial susceptibility testing against a panel of commonly prescribed antibiotics. The findings revealed that Escherichia coli was the predominant bacterial isolate associated with urinary tract infections. The isolate exhibited complete resistance (100%) to ampicillin, indicating that this antibiotic is no longer effective for empirical treatment of E. coli-associated UTIs in the studied population. Low susceptibility rates were observed for vancomycin (23.1%) and clindamycin (23.1%), as well as cefotaxime (12.3%), cefixime (21.5%), nalidixic acid (20.0%), ciprofloxacin (26.2%), levofloxacin (24.6%), trimethoprim (24.6%), and ceftazidime (29.2%). In contrast, higher susceptibility was recorded for gentamicin (75.4%), amikacin (50.8%), azithromycin (89.2%), imipenem (90.8%), while tobramycin demonstrated the highest effectiveness, with 100% sensitivity against the isolated E. coli strains. The study highlights the alarming increase in antimicrobial resistance among uropathogenic E. coli isolates and emphasizes the importance of routine antimicrobial susceptibility testing before initiating antibiotic therapy. The findings also support the use of imipenem, tobramycin, gentamicin, and azithromycin as more effective therapeutic options in the study area while discouraging the empirical use of ampicillin because of its complete resistance. Continuous monitoring of resistance patterns and the implementation of antibiotic stewardship programs are essential to optimize treatment outcomes, reduce the spread of resistant strains, and improve the management of urinary tract infections.

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