Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic review

Background: Urinary tract infections (UTIs) are a prevalent global health issue and are intensified by the rise of antibiotic resistance and biofilm formation. Analyzing 18 studies published between 2019 and 2024, this review aims to evaluate the antibiotic resistance patterns and biofilm-forming ab...

Full description

Saved in:
Bibliographic Details
Main Authors: Abigail Anne Ferrer, Samson Decasa, Juliana Carlidy Elauria, Jalen Rose Esguerra, Earl Adriane Cano, Angela Nole Shayenne Coderos, Denise Alexandra Cruz, Den Marc Exala
Format: Article
Language:English
Published: Zagazig University, Faculty of Medicine 2025-08-01
Series:Microbes and Infectious Diseases
Subjects:
Online Access:https://mid.journals.ekb.eg/article_423064_8e46d464b6d3cadf133597ec715b0c90.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849402933052964864
author Abigail Anne Ferrer
Samson Decasa
Juliana Carlidy Elauria
Jalen Rose Esguerra
Earl Adriane Cano
Angela Nole Shayenne Coderos
Denise Alexandra Cruz
Den Marc Exala
author_facet Abigail Anne Ferrer
Samson Decasa
Juliana Carlidy Elauria
Jalen Rose Esguerra
Earl Adriane Cano
Angela Nole Shayenne Coderos
Denise Alexandra Cruz
Den Marc Exala
author_sort Abigail Anne Ferrer
collection DOAJ
description Background: Urinary tract infections (UTIs) are a prevalent global health issue and are intensified by the rise of antibiotic resistance and biofilm formation. Analyzing 18 studies published between 2019 and 2024, this review aims to evaluate the antibiotic resistance patterns and biofilm-forming abilities of UTI-causing bacteria, identify the most prevalent species, and discuss contributing prevalence factors to inform future mitigation strategies. The current review found a high prevalence of resistance to commonly used antibiotics, especially penicillin, among Enterobacterales, with Escherichia coli and Proteus vulgaris exhibiting significant multidrug resistance (MDR). Nitrofurantoin's effectiveness was also reduced in certain biofilm-forming bacteria, with susceptibility rates as low as 15%. Conversely, most isolates in the studies were consistently found to be susceptible to imipenem (89% to 100%) and meropenem (70.3% to 100%). Furthermore, biofilm formation rates ranged from 36.5% to 100%, with a median prevalence of 75.5%. E. coli was the most frequently isolated bacteria (66.7%), displaying varying biofilm formation rates influenced by external factors and strain diversity. Other significant biofilm producers, such as Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus saprophyticus, Proteus mirabilis, P. vulgaris, and Klebsiella pneumoniae, were also noted. 61.11% of the studies revealed a strong association between biofilm formation and MDR. Notably, P. mirabilis exhibited the highest proportion of strong biofilm producers and MDR prevalence, which was linked to specific resistance genes. Similarly, S. aureus, K. pneumoniae, and E. coli showed substantial MDR due to biofilm formation, particularly resistance to β-lactams, cephalosporins, and fluoroquinolones. P. aeruginosa and P. vulgaris, despite lower strong biofilm formation rates, presented significant resistance mechanisms, including efflux pumps and extended spectrum β-lactamase (ESBL) production. These findings emphasize the challenges in treating biofilm-mediated UTIs, highlighting the need for the continuous monitoring of resistance trends and further research on new therapeutic approaches. Future research should investigate the long-term evolution of bacterial resistance and the genetic adaptations of biofilms to inform strategies for mitigating resistance and improving UTI treatment outcomes.
format Article
id doaj-art-dd0abf75ca38414bb322e1c9f6005b92
institution Kabale University
issn 2682-4132
2682-4140
language English
publishDate 2025-08-01
publisher Zagazig University, Faculty of Medicine
record_format Article
series Microbes and Infectious Diseases
spelling doaj-art-dd0abf75ca38414bb322e1c9f6005b922025-08-20T03:37:23ZengZagazig University, Faculty of MedicineMicrobes and Infectious Diseases2682-41322682-41402025-08-01636023604210.21608/mid.2025.362955.2574423064Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic reviewAbigail Anne Ferrer0Samson Decasa1Juliana Carlidy Elauria2Jalen Rose Esguerra3Earl Adriane Cano4Angela Nole Shayenne Coderos5Denise Alexandra Cruz6Den Marc Exala7Department of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesDepartment of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesDepartment of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesDepartment of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesDepartment of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesDepartment of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesDepartment of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesDepartment of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Sampaloc, Manila, PhilippinesBackground: Urinary tract infections (UTIs) are a prevalent global health issue and are intensified by the rise of antibiotic resistance and biofilm formation. Analyzing 18 studies published between 2019 and 2024, this review aims to evaluate the antibiotic resistance patterns and biofilm-forming abilities of UTI-causing bacteria, identify the most prevalent species, and discuss contributing prevalence factors to inform future mitigation strategies. The current review found a high prevalence of resistance to commonly used antibiotics, especially penicillin, among Enterobacterales, with Escherichia coli and Proteus vulgaris exhibiting significant multidrug resistance (MDR). Nitrofurantoin's effectiveness was also reduced in certain biofilm-forming bacteria, with susceptibility rates as low as 15%. Conversely, most isolates in the studies were consistently found to be susceptible to imipenem (89% to 100%) and meropenem (70.3% to 100%). Furthermore, biofilm formation rates ranged from 36.5% to 100%, with a median prevalence of 75.5%. E. coli was the most frequently isolated bacteria (66.7%), displaying varying biofilm formation rates influenced by external factors and strain diversity. Other significant biofilm producers, such as Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus saprophyticus, Proteus mirabilis, P. vulgaris, and Klebsiella pneumoniae, were also noted. 61.11% of the studies revealed a strong association between biofilm formation and MDR. Notably, P. mirabilis exhibited the highest proportion of strong biofilm producers and MDR prevalence, which was linked to specific resistance genes. Similarly, S. aureus, K. pneumoniae, and E. coli showed substantial MDR due to biofilm formation, particularly resistance to β-lactams, cephalosporins, and fluoroquinolones. P. aeruginosa and P. vulgaris, despite lower strong biofilm formation rates, presented significant resistance mechanisms, including efflux pumps and extended spectrum β-lactamase (ESBL) production. These findings emphasize the challenges in treating biofilm-mediated UTIs, highlighting the need for the continuous monitoring of resistance trends and further research on new therapeutic approaches. Future research should investigate the long-term evolution of bacterial resistance and the genetic adaptations of biofilms to inform strategies for mitigating resistance and improving UTI treatment outcomes.https://mid.journals.ekb.eg/article_423064_8e46d464b6d3cadf133597ec715b0c90.pdfurinary tract infectionsantibiotic resistancebiofilm formationmultidrug resistance
spellingShingle Abigail Anne Ferrer
Samson Decasa
Juliana Carlidy Elauria
Jalen Rose Esguerra
Earl Adriane Cano
Angela Nole Shayenne Coderos
Denise Alexandra Cruz
Den Marc Exala
Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic review
Microbes and Infectious Diseases
urinary tract infections
antibiotic resistance
biofilm formation
multidrug resistance
title Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic review
title_full Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic review
title_fullStr Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic review
title_full_unstemmed Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic review
title_short Antibiotic resistance of biofilm-forming bacteria causing urinary tract infections: A systematic review
title_sort antibiotic resistance of biofilm forming bacteria causing urinary tract infections a systematic review
topic urinary tract infections
antibiotic resistance
biofilm formation
multidrug resistance
url https://mid.journals.ekb.eg/article_423064_8e46d464b6d3cadf133597ec715b0c90.pdf
work_keys_str_mv AT abigailanneferrer antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview
AT samsondecasa antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview
AT julianacarlidyelauria antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview
AT jalenroseesguerra antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview
AT earladrianecano antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview
AT angelanoleshayennecoderos antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview
AT denisealexandracruz antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview
AT denmarcexala antibioticresistanceofbiofilmformingbacteriacausingurinarytractinfectionsasystematicreview