Detection of Biofilm Formation and Antibiotic Susceptibility in Escherichia coli Isolated From the Urine of Pregnant Women at Mnazi Mmoja Hospital, Zanzibar, Tanzania

Abstract

Background: Escherichia coli is one of the species mostly involved in biofilm formation, being the most important
cause of relapse or chronic urinary tract infections. To develop alternative biofilm-fighting treatments, it is important to
understand which types of E. coli form biofilms.
Study objectives: To detect biofilm formation and antibiotic susceptibility among E. coli isolated from the urine of
pregnant women at Mnazi Mmoja Hospital, Zanzibar, Tanzania.
Methodology: Hospital-based cross-sectional study was conducted at Mnazi Mmoja Hospital in Zanzibar. A questionnaire
was used to collect all the information regarding demographic characteristics. Midstream urine samples were collected
and sent to the laboratory for culture, sensitivity, and biofilm tests. Positive growth culture was subjected to differential
identification tests such as Motility Indole Ornithine, Urea, and citrate. The antimicrobial susceptibility test was conducted
on all E. coli species. Biofilm production was detected using a microtitre plate assay. IBM SPSS Statistics for Windows
version 20.0 (IBM Corp, Armonk, NY, USA) was used in the analysis of data.
Result: Out of 400 participants, significant growth of E. coli was detected in 22 (5.5%), of which 6 (27.3%) were
symptomatic and 16 (72.7%) were asymptomatic. Of all E. coli isolates, 22 (100%) were biofilm formers, 15 (68.2%)
were resistant to Amoxicillin & clavulanic acid, and 16 (72.7%) were resistant to Ampicillin. However, all isolates were
sensitive to Gentamycin, Ceftriaxone, Nitrofurantoin, Norfloxacin, and Meropenem, while 21 (95.4%) were sensitive
to Ciprofloxacin and Nalidixic acid.
Conclusion: We revealed that E. coli that formed biofilms showed significant levels of antibiotic resistance to commonly
used drugs.