Biofilm formation and antimicrobial resistance of uropathogenic Escherichia coli and Klebsiella pneumonia strains isolated from pregnant women in Kerman, Iran

Authors

Department of Microbiology, Kerman Branch, Islamic Azad University, Kerman, Iran

Abstract

Introduction: Urinary tract infections are the common medical problems in pregnant women and associated bacteria
produce biofilm which protects them from antibiotics. Aim of this study was to determine the pattern of antibiotic resistance and biofilm formation by Escherichia coli and Klebsiella pneumoniae isolated from urine of pregnant women in Kerman, Iran.
 Materials and Methods: 107 urine samples were collected from pregnant women. Identification was performed by biochemical tests. Antibiotic sensitivity by disc diffusion method and minimum inhibitory concentration (MIC) by
agar dilution method were performed. The cell surface hydrophobicity (CSH) behavior of those strains and their ability to form biofilm on glass and propylene surfaces was evaluated in static and shake conditions. The effect of antibiotics on biofilm formation ability was also determined on the catheter surface.
Results: From 80 positive cases, 35 isolates of Escherichia coli and 15 isolates of Klebsiella pneumoniae were selected for this research. The Maximum resistance and sensitivity of isolates were observed about amoxicillin and imipenem, respectively. All isolates with CSH higher than 70% showed better biofilm formation even though on propylene in shaking state. Treatment of culture with 0.5 MIC (μg/ml) and 0.25 MIC (μg/ml) of selected antibiotics significantly reduced the adhesion ability of isolates.
Conclusion: The survey therefore came to the conclusion that similar researches should be continuously repeated in
different medical centers to test antimicrobial susceptibility as well as diagnosing and quantifying biofilm infection which surely achieved data help to find appropriate therapeutic way against UTI in pregnancy.

Keywords

1. Ayoyi AO, Kikuvi G, Bii C, Kariuki S. Prevalence, aetiology and antibiotic sensitivity profile of asymptomatic bacteriuria isolates from pregnant women in selected antenatal clinic from Nairobi, Kenya. Pan Afr Med J. 2017; 26(1):41. 2. Rohini UV, Reddy GS, Kandati J, Ponugoti M. Prevalence and associate risk factors of asymptomatic bacteriuria in pregnancy with bacterial pathogens and their antimicrobial susceptibility in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2017; 6(2):558-62. 3. Smaill FM, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev. 2015; 8:CD00490. 4. Ghafari M, Baigi V, Cheraghi Z, Doosti-Irani A. The prevalence of asymptomatic bacteriuria in Iranian pregnant women: a systematic review and meta-analysis. PLoS One. 2016; 11(6):e0165114. 5. Foxman B, Barlow R, D’Arcy H, Gillespie B, Sobel JD. Urinary tract infection: self-reported incidence and associated costs. Ann Epidemiol. 2000; 10(8):509-515. 6. Lüthje P, Brauner A. Virulence factors of uropathogenic E. coli and their interaction with the host. Adv Microb Physiol, 2014; 65(4):337-372. 7. AgarwalJ, Srivastava S, Singh M. Pathogenomics of uropathogenic Escherichia coli. Indian J Med Microbiol. 2012; 30(2):141-149. 8. Jalilian S, Rokhbakhsh-Zamin F. Evaluating the ability of Biofilm formation in Escherichia coli isolated from clinical samples in Zahedan.Pars Journal of Medical Sciences. 2017; 15(1): 36-42. 9. Khodadadian R, Khorshidi A, Safari M, Gilasi HR. Prevalence of metallo-beta-lactamase enzyme and patern of antibiotic resistance in Klebsiellapnomoniae isolated from patients with urinary tract infection in Qom city during 2013-2014. Feyz, Journal of Kashan University of Medical Sciences. 2017; 21(4):390-397. 10. Amini F, Karimpour HA, Hasani Sh, Mohamadi S, Azizi M. Antibiotic resistance pattern of urinary tract infection pathogens in children of Kermanshah in 2015. Razi Journal of Medical Sciences. 2017; 24(155):20-27. 11. Jalilian S, Farahani A, Mohajeri P. Antibiotic resistance in uropathogenic Escherichia coli isolated from urinary tract infections out-patients in Kermanshah. Int J Med Public Health. 2014; 4(1):75-81. 12. Molazade A, Shahi A, Najafipour S, Mobasheri F, Norouzi F, Abdollahi Kheirabadi S,Ashraf Mansuri J, Gholami MS. Antibiotic Resistance Pattern of Bacteria CausingUrinary Tract Infections in Children of Fasa During the Years 2012 and 2014. Journal ofFasa University of Medical Sciences. 2015; 4(4): 492-499. 13. Aghamahdi F, Hashemian H, Shafiei M, Akbarian Z, Rostam Nejad M, Fallah Karkan M. Etiologies andantibiotic resistance patterns in infants with urinary tractinfections hospitalized in children medical center, Rasht,Iran. Iran J Neonatal IJN. 2013; 4(2):21-25. 14. Forbes BA, Sahm DF, Weissfeld AS. Study Guide for Bailey & Scott's Diagnostic Microbiology. 12th ed. Missouri. Mosby Elsevier; 2007. 15. Kazemipour N, Dusane DH, Dhakephalkar PK, Rokhbakhsh-Zamin F, ZinjardeSS, Chopade BA. Biofilm formation by Acinetobacter baumannii strains isolatedfrom urinary tract infection and urinary catheters. FEMS Immunol Med Microbio. 2011; 162(3):328-338. 16. Azemat Eslamtalab E, Kazemipour N. Biofilm formation and antibiotic resistance ofAcinetobacter spp. isolated from skin and wound infections. IJBPAS. 2015; 4(10):568-576. 17. National Committee for Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; twenty five informational supplement. 2015; 35(3):45-154. 18. Jones DS, Adair CG, Mawhinney WM, Gorman SP. Standardization and comparison of methods employed formicrobial cell surface hydrophobicity and chargedetermination. Int J Pharm. 1996; 131(1): 83–89. 19. Tomaras AP, Dorsey CW, Edelmann RE, Actis LA.Attachment to and biofilm formation on abiotic surfacesby Acinetobacter baumannii: Involvement of a novelchaperone usher pili assembly system. Microbiology. 2003; 149(12): 3473–84. 20. O’Toole GA, Pratt LA, Watnick PI, Newman DK, Weaver VB, Kolter R. Genetic approaches to the study of biofilms.Method Enzymol. 1999; 310(1):91–109. 21. Moulana Z, Asgharpour F, Ramezani T. Frequency of the Bacterial Causing Agents in Urinary Tract Infection and Antibiotic Pattern Samples Sent to Razi Laboratory, Babol 2008-2009: A Short Report. 2012; 6(12):489-494. 22. Hamidi-Farahani R, Tajik AR, Noorifard M, Keshavarz A, Taghipour N, Hossieni-Shokouh J. Antibiotic resistance pattern of Escherichia coliisolated from urineculture in 660 Army clinical laboratory center in Tehran 2008. J Army Univ Med Sci. 2012; 10 (1) : 45-49 23. Mohammadi M, Ghasemi E, Mokhayeri H, Pournia Y, Boroun H.Antimicrobial Resistance Patterns of Escherichia coliDetected from Hospitalized Urine Culture Samples. Asian Journal of Biological Sciences. 2010; 3(4):195-201. 24. Gezmu T, Regasa B, Manilal A, Mama M, Hailu T, Merdekios B. Prevalence, diversity and Antimicrobial Resistance of uropathogenic bacterial isolates sourced from the UTI patients of Arba Minch Province, Ethiopia. iMedPub Journals. 2016; 7(3):81-86. 25. Adeyemi AO, Evbaziegbere Gideon E, Eromosele IH, Evelyn Chimerenma A, Sunday Oladokun O, Eunice Ogochukwu U, et al. Antibiotics Susceptibility Patterns of some Uropathogens to Nitrofurantoin and Nalidixic Acid among Pregnant Women with Urinary Tract Infections in Federal Medical Centre, Bida, Niger-State, North Central, Nigeria. American Journal of Epidemiology and Infectious Disease. 2014; 2(4):88-92. 26. Abdolahi AR, Mehr Azma M. Evaluation of antibiotic susceptibility and resistance in urinary infections, Imam Khomeini Hospital, Tehran. Journal of Jahrom University of Medical Sciences. 2009; 7(9):59-66. 27. Kovács B. The role of bacterial hypermutation in biofilm formation and antibiotic resistance in urinary tract infections caused by pathogens of the Enterobacteriaceae family. PhD Thesis. Rennes, France: Université de Rennes; 2014. 28. Naparstek L, Carmeli Y, Navon-Venezia Sh, Banin E. Biofilm formation and susceptibility to gentamicin and colistin of extremely drug-resistant KPC-producing Klebsiella neumonia. Journal of Antimicrobial Chemotherapy. 2014; 69(4):1027-1034. 29. Rangari A, Sharma S, Tyagi N, Singh P, Singh G, Thakur R. Antibiotic Susceptibility Pattern of Bacterial Uropathogens Isolated from Patients at a Tertiary Care Hospital in Western Uttar Pradesh of India. Int.J.Curr.Microbiol.App.Sci. 2015; 4(10): 646-657 30. Kazemian H, Heidari H, Ghanavati R, Mohebi R, Ghafourian S, Shavalipour A, et al. Characterization of Antimicrobial Resistance Pattern and Molecular Analysis among Extended Spectrum β-Lactamase-Producing Escherichia coli. Pharm Sci. 2016; 22(4):279-284. 31. Fasalu Rahiman OM, Balasubramanian T, Shejina M, Mohthash Musambil: A Review on Urinary Tract Infection in Pregnancy. International Journal of Pharma Research & Review. 2015; 4(2):26-33.