E.coli Pathogens Biofilms In Urinary Tract Infections

This essay focuses on the literature review of E.coli pathogens biofilms in urinary tract infections. It discusses the detection of biofilms and their correlation with antibiotic resistance. The article critically analyzes the current research and evaluates the contribution of the literature to advancing the field of research.

E.coli Pathogens Biofilms In
Urinary Tract infections

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Identify a comprehensive range of relevant literature to the topic.........................................1
Link the findings of your literature search to current questions and new research in the field to
identify a sub-topic to focus on for your review....................................................................2
Critically analyse the current research literature in your chosen sub-topic............................3
Evaluate the contribution of the literature you discuss to advancing the field of research....5
Assess the quality and reliability of the data in the literature.................................................6
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Escherichia coli are known to be a gram negative bacterium and present in human gut. Biofilms
are communities of microorganisms and their functional products assisting bacteria to attach to
uroepithelial cells. E. coli refers to a bacterium which is responsible for having around 70% to
95% of urinary tract infection that may occur in human beings (Sevanan, Pongiya and
Peedikavil, 2011). It develops different types of infection which are commonly known as UTISs
(urinary tract infections). In context of this assignment, it is based on the E. coli pathogens
biofilms in urinary tract infections with the help of reviewing an article. This essay will focus on
literature of selected topic and identify the sub topics to conduct review. It will also include the
analyse current research literature and evaluate the contribution of the same. The quality and
reliability of the data mentioned on literature is given below.
MAIN BODY
Identify a comprehensive range of relevant literature to the topic
E. coli is a pathogen that is accountable for present in gut of human beings due to which various
types of urinary tract infections takes place. The selected article is based on the topic of
‘Detection of biofilm among uropathogenic Escherichia coli and its correlation with antibiotic
resistance pattern’. It is observed that UTIs are known as serious health issue in regards to
antibiotic resistance for which biofilms preparation being a prime regarding this problem. The
given investigation focus on the research aim of performing in vitro detection of biofilms among
E. coli strains isolated from urine as well as for correlating their susceptibility pattern with
biofilm formation (Saroj and et.al., 2012).
It has been evaluated that around 100 E. coli strains isolated from infected individuals facing
problem of urinary tract infections to carry out the study. The criterion if identifying the bacterial
has been performed with the help of Gram staining, biochemical tests and colony morphology to
determine E. coli. However, biofilm got detected through several methods such as Congo red
agar (CRA) method, tube method (TM) and tissue culture plate (TCP) method. The procedure of
Kirby-Bauer disc diffusion was carried out on Muller-Hinton agar plate in order to perform
antimicrobial sensitivity testing.
This article has several findings such as 49 (49%) and 51 (51%) were belongs to catheterised and
non-catheterised patients out of collected sample of 100 E. coli strains. It consist the positive
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results in terms of biofilms through CRA, TM and TCP method that were 49 (49 %), 55 (55 %)
and 69 (69 %) accordingly. It has been founded that biofilm producers are responsible for
showing maximum resistance against the co-trimoxazole (73.9%), gentamicin (94.2) and
imipenem (11.6%) while comparing with nonbiofilm producers. The significant link was
identified among resistance for antibiotic as well as biofilm formation with a P = 0.01 (<0.05).
Link the findings of your literature search to current questions and new research in the field to
identify a sub-topic to focus on for your review.
Another study was analysed which is based on the topic, ‘Microbial biofilms in urinary tract
infections and prostatitis: Aetiology, pathogenicity and combating strategies. It includes that
urinary tract infections can be considered as one of the most essential causes of morbidity and
health care spending among population of all ages (González and et.al., 2017). Basically, it is
observed that bacterial biofilms plays an important role in terms of developing various kinds if
UTIs among people and they are accountable for persistent infections leading for recurrences as
well as relapses. Meanwhile, it has been founded that UTIs linked through microbial biofilms
that are produced on catheters have high possibility of all nosocomial infections. The rich source
of such biofilms is Gram-negative bacteraemia among sick individuals hospitalised in hospitals.
The reason behind this investigation is to carry out mini review is to evaluate the role of
microbial biofilms in aetiology of female UTI as well as differentiated make prostatitis
syndromes along with their consequences and possible challenges for therapy. However, it has
been examined that E. coli is most frequent agent for developing UTI but several other microbes
are also responsible for the same. It includes certain other microorganisms such as Proteus
mirabilis, Klebsiella pneumoniae, Pseudomonas
aeruginosa, Enterococcus spp., Enterobacter spp., group B Streptococcus, and Staphylococcus
saprophyticus.
On the other hand, this study also focuses on role of microbial biofilms in aetiology of
UTIs in women as human vagina and bacterial communities indicates balanced mutualistic
association (Panda, Chaudhary and Dube, 2016). It includes the role of biofilms in prostatitis and
urethritis in men as the several microbes like S. epidermidis, enterococci, and diphtheroids are
found in anterior urethra of males in frequent manner. Meanwhile, it is observed that normal
micro biota residing in terms of urethra that must be taken into consideration in a clinical
interpretation of urine cultures. However, it also consist information about catheter patients as
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they have high risk of acquiring urinary tract infections with utilisation of indwelling devices. In
addition to this, the most important aspect of this investigation is about antimicrobial strategies
in respect of fighting against urinary tract biofilms. It includes the cationic aminoglycosides is
favourable that get trapped by negatively charge of polymers for biofilm matrix, the beta lactams
and glycopeptides diffusion decreased. On the other hand, the fluoroquinolones and rifampicin
are accountable for penetrating immediately along with explaining the rapid installation of
bacterial effect and macrolides (Rashmi and Mahantesh, 2016). Moreover, natural antimicrobial
compounds can be used like Ibicella corpora lutea, Grandis coccinea extracts, volatile oils
from Rosmarinus officinalis and Salvia officinalis, Mentha piperita, Eugenia caryophyllata,
ylang ylang, vanilla, patchouli, Satureja hortensis, and lichens.The nanoparticle like metal
cations has important antimicrobial features, antimicrobial coatings, enzyme inhibitors, catheters
coated with T4 bacteriophages and quorum sensing inhibitors.
Critically analyse the current research literature in your chosen sub-topic
Considering the above article, it has been reviewed that urinary infections are mostly known to
be bacterial infections as they were caused by a bacteria. It is observed that around 95 % of total
UTIs were caused due to presence of bacteria. Meanwhile, it has been analysed that E. coli can
be consider as an essential member of normal intestinal micro flora in human beings and other
mammals. This bacterium can be called as a highly versatile bacterium which may act as a
harmless gut commensal in regards to intra or extra intestinal pathogens. Escherichia coli are
also a frequent colonizer in related to medical devices and initial reason for recurrent urogenital
infections. Meanwhile, biofilms producers exhibit an altered phenotype in context of growth rate
and transcription. It has been reviewed that biofilm is accountable for restricting diffusion og
substances as well as binding properties of antimicrobials. However, it will facilitate in providing
effective resistance power for biofilm cells against large molecules like antimicrobial proteins
lysozyme and complement accordingly. As per findings of national institutes of a health, it has
been stated that around 60% of microbial infections takes place because of biofilms (Microbial
Biofilms in Urinary Tract Infections and Prostatitis: Etiology, Pathogenicity, and Combating
strategie, 2016).
It has been analysed that production of biofilms in E. coli is responsible for promoting the
colonisation that leads to increase rate of urinary tract infections in which some of them very
difficult to be treated as they exhibit multidrug resistance (MDR). It includes the fact about
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prevalence of biofilm that is reported around range 60 % to 70 % among uropathogenic E. coli.
However, it has been analysed that there are number of medicinal compounds which are helpful
in reducing the criterion of reducing amount of biofilms that is formed by E. coli. It consist
cephalosporins, aminoglycosides and fluoroquinolones plays an important role for reduction of
biofilm formation which facilitate to decrease urinary tract infections. It has been reviewed that
cephalothin, ceftazidime, ceftafloxacin reduce biofilm biomass in susceptible strains whereas
lowered the same in context of resistant strains (Wayne, 2014).
The examination of urine has been conducted through macroscopic method, microscopic
technique and plating of urine sample. It includes the centrifugal of urine at 200 rpm for 15
minutes and then wet preparation of sediment examined. Basically, the standard loop technique
was used for plating if urine sample that cultured via semi quantitative method on MacConkey’s
agar, cystine lactose electrolyte deficient agar medium and incubated at 37 °C for 24 hour
(Ponnusamy, Natarajan and Sevanan, 2012). However, the biofilm detection has been carried out
with the help of Congo Red agar method in which solid medium containing brain heart infusion
broth supplement with 5% sucrose and Cong red inoculated as well as incubated aerobically for
around 24 to 48 hours at the temperature of 37 °C. The positive results in this method show
about black colonies with a dry crystalline consistency and weak biofilm generated generally
remain pink.
In addition to this, tube method was also used in this study that consist use of Trypticase Soy
Broth with 1 % glucose i.e. approximately (10 ml) inoculated through loopful colonies from
overnight culture plate. It indicates that positive film lining the wall and bottom of the tub shows
about positive whereas ring developing the liquid surface reflects about negative. Meanwhile, it
has been founded that tissue culture plate methods was also considered in order to isolate from
fresh agar plates were inoculated in Tryticase Soy Broth and incubated for 37 °C for 24 hours
that made diluted with fresh Trypticase Soya Broth in 1 in 100 dilution. It consist the antibiotic
sensitivity testing which was conducted with the help of Kirby-Bauer disc diffusion process by
utilising Clinical Laboratory Standards Institute guidelines. It consist the use number of
antibiotics such as ampicillin, co-trimoxazole, nitrofurantoin, ciprofloxacin, amoxicillin-
clavulanic acid, norfloxacin, gentamicin, piperacillin with tazobactam, cephalexin, nalidixic acid,
amikacin, cefoperazone with sulbactam, ceftazidim with clavulanic acid and imipenem.
Moreover, it has been evaluated that Chi-square (χ2) as conducted, P value and correlation
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coefficient (r) utilising InStat Software in regards to carry out statistical analysis. Hence, the P <
0.05 is known as the significance of statistics.
With the help analysing the selected literature, the 100 strain samples has been collected consist
catheterised and non-catheterised patients. It is founded that E. coli isolates subjected for
production of biofilms in which around 69 % strain seems positive for biofilm production
whereas 49 %, 55 % and 69 % were positive by Congo red agar, tube method and TCP method.
Besides of this, it has been analysed that biofilm production was maximum in respect of
catheterised individuals. It has been analysed that 89 % and 5 % strains were biofilm and non-
biofilms among all the catheterised patients i.e. 49 % via TCP method. The TM method indicates
about 38 (77.6 %) and 11 (10.3 %) were observed as biofilm and non biofilm producers whereas
CRA shows 77.6 % strains as biofilms and 22.4 % as non biofilms. On the other hand, it has
been analysed that TCP method identified 49 % as biofilm producers and 51 % non biofilm
developers whereas TM process detected 33.3 % biofilm and 66.7 % non biofilm producers.
However, CRA shows that 21.6 % and 78.4 % bio and non bio films developers. Moreover, the
study of overall strain samples such as 89.7 % and 49 % of E. coli strains were biofilm producers
in context of catheterised patients (Mittal, Sharma and Chaudhary, 2015). In contrary to this, a
significant correlation was founded among production of biofilms and catheterisation. It has been
evaluated that people with age between 21 to 30 years get more affected among female i.e. 17 %
and 51 to 60 years among make i.e. 17 %. In context of both male and female patients, it is
observed that maximum age group of 21 to 30 years get affected i.e. 24 % followed by 51 to 60
years i.e. 21 % accordingly.
Evaluate the contribution of the literature you discuss to advancing the field of research
Considering the give article, it has been analysed that the study helps to understand more about
biofilm detection in E. coli will support in development of better treatment. It includes the
detailed literature about formation of biofilms which provide support to researcher to gather
more information in relation to developing an advanced treatment through the relevant health
problems can be treated. On the other hand, this study contributes in detection of biofilm
formation as well as antibiotic susceptibility pattern that provide help in terms of selecting an
appropriate antibiotic therapy. It is helpful to understand about the bacteria that are rich in
producing biofilm in regards to number of recalcitrant infections and they are much difficult for
eradicating. The given investigation put a great contribution in context of gathering information
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so that effective vaccines or medications can be developed in order to treat relevant health
problem among people.
In respect of current research, it is observed that majority of biofilms are produced by E. coli
which is mostly in catheterised individuals and this is proved by other authors by their
investigations in terms of link of biofilm producing bacteria with urinary catheter. It consist that
the knowledge about patient with catheters has more ratio of bacteria developing biofilsm which
is required to be focused by care professionals (Detection of biofilm among
uropathogenic Escherichia coli and its correlation with antibiotic resistance pattern, 2019). The
present study cotrubutes in meical field by gathering attention of medical practitioners towards
patients having catheters should be provided with special care to avoid urinary tract infections as
they are more likely to gat suffered from the same. Meanwhile, it is necessary to focus on
effective medicinal researcher in order to invent strong treatment for treating the urinary tract
infections and avoiding relevant problems among people. Moreover, it is required to make
medicines that work on biofilm producing bacteria so that it can be used for patient wellbeing.
Assess the quality and reliability of the data in the literature
The quality of the current research is effective in terms of following all the ethical principles and
factors for carrying out entire study. It includes the use of recent research paper having more
authentic and accurate information in respect of gaining appropriate results. However, it consist
the investigator take ethical approval from specific authorities in order to conduct the overall
study in terms of gaining better outcomes. Moreover, it is helpful to gain data in the literature
from more authentic research papers in terms of gathering more accurate information which
facilitate to attain better outputs respectively.
CONCLUSION
From the above assignment, it has been concluded that biofilms are contribution to interrupt in
action of antibiotics which develop risk of occurring urinary tract infections among people. It
includes that catheter holder patients have more risk to gather such infections which are develop
by Gram negative bacteria like E. coli.
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REFERENCES
Books and journals
Sevanan M., Pongiya U. and Peedikavil N.J., 2011. Antimicrobial susceptibility pattern of
biofilm producing Escherichia coli of urinary tract infections. Curr Res
Bacteriol. ;4:73–80.
Saroj G. and et.al., 2012. Correlation between biofilm formation of uropathogenic Escherichia
coli and its antibiotic resistance pattern. J Evol Med Dent Sci. ;1:166–75.
González M.J and et.al., 2017. Effect of different antibiotics on biofilm produced by
uropathogenic Escherichia coli isolated from children with urinary tract
infection. Pathog Dis. ;75:1–9.
Panda P.S., Chaudhary U., Dube S.K., 2016. Comparison of four different methods for detection
of biofilm formation by uropathogens. Indian J Pathol Microbiol. ;59:177–9.
Rashmi M.K., Mahantesh B.N., 2016. Characterization and antibiotic susceptibility pattern of
coagulase negative staphylococci with special reference to methicillin resistance. Int J
Curr Microbiol App Sci. ;5:114–20.
Wayne, P.A., 2014. USA: Clinical and Laboratory Standards Institute;. Performance Standards
for Antmicrobial Susceptiblity Testing; Twenty-fourth Informational Supplement.
Ponnusamy P., Natarajan V., Sevanan M., 2012. In vitro biofilm formation by
uropathogenic Escherichia coli and their antimicrobial susceptibility pattern. Asian Pac
J Trop Med. ;5:210–3.
Mittal S., Sharma M., Chaudhary U., 2015 Biofilm and multidrug resistance in
uropathogenic Escherichia coli. Pathog Glob Health. ;109:26–9.
Online
Detection of biofilm among uropathogenic Escherichia coli and its correlation with antibiotic
resistance pattern. 2019. [Online]. Available through:<
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437818/>
Microbial Biofilms in Urinary Tract Infections and Prostatitis: Etiology, Pathogenicity, and
Combating strategies. 2016. [Online]. Available through:<
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198165/>
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