Comparison of detection methods of biofilm formation and susceptibility profile of uropathogenic escherichia coli clinical isolates in Uganda
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Biofilm production is a phenomenon where one or more types of microorganisms form single entities of communities on various surfaces. Alarmingly, these surfaces may include medical implants such as catheters and intrauterine devices which worsens the treatment course of hospitalized patients especially those in the Intensive Care Units. This is due to the fact that biofilms act as arenas of exchange of important traits such as antimicrobial resistance through horizontal gene transfer. Biofilms formed by uropathogenic E.coli are linked to the causes of persistent and recurrent urinary tract infections in populations. This has made treatment of these infections more expensive to manage in terms of both medical and time costs. Therefore, accurate detection of biofilms is key in the management of biofilm associated infections. This studyaimed at the evaluation of the three commonly used biofilms detection methods; that is, Congo Red Agar method, tube method and the microtitre plate method among UPEC clinical isolates in the clinical microbiology laboratory, department of medical microbiology, school of biomedical sciences. Among the 200 UPEC isolates used, the microtitre method detected 135 isolates (67.5%) as positive for biofilm formation, Congo red method detected 125 isolates (62.5%) and tube method detected 54 isolates (27%); therefore, the microtiter method was more sensitive than the congo red and tube methods. The study also found out that 67.5% of the UPEC isolates were biofilm formers and that Uropathogenic E.coli isolates exhibited great resistance to sulphonamides, quinolones, and lower class beta-lactams such as ampicillin, cefuroxime and ceftriaxone. Antimicrobial resistance was more exhibited among biofilm forming UPEC isolates. Therefore, according to the findings, this study recommends that the Microtitre method is the standard phenotypic method that should be used to determine biofilm formation in bacteria. Routine susceptibility testing should also be done to inform clinicians about a proper treatment regimen for urinary tract infections. This will reduce dissemination of antimicrobial resistance elements and also reduce morbidity. The study further recommends routine testing of UPEC isolates for biofilm formation so as to guide on treatment of catheterized patients and also more studies should be done compare more biofilm formation detection methods. This study was limited in resources to compare more methods such as the PCR, bioluminescent assay, piezoelectric sensors, and fluorescent microscopic examination.