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Background The capacity of antibiotics to modulate bacterial virulence has raised concerns over the appropriateness of antibiotic therapies, including when dosing strategies fall below sub-therapeutic levels. In this work, we investigated the ability of antibiotics to influence virulence in  Escherichia coli  isolated from urinary tract infection (UTI). Results Out of 120 isolates, 32.5% carried  pap , 21.7% carried  hlyA , and 17.5% carried  cnf . The predominant B2 phylogroup was significantly associated with the quinolone-resistant isolates. A significant association was seen between the presence of  hlyA  hemolysin and susceptibility to ceftriaxone and ciprofloxacin ( P  &lt; 0.05). Sub-inhibitory concentrations of both antibiotics reduced the levels of  hlyA  expression and hemolysis in isolates treated with antibiotics compared to untreated isolates ( P  &lt; 0.05). Growth rate assay showed that the decrease in  hlyA  expression was not an effect of decreased growth rate. Conclusion Our study indicated the inhibitory effect of ciprofloxacin and ceftriaxone on the level of hemolysis, suggesting that the sub-inhibitory concentrations of these antibiotics may affect the outcome of infections. Further studies, including animal models may elucidate the outcome of virulence modulation by these antibiotics in UTI pathogenesis.

bmc microbiology

Characterization of Escherichia coli isolated from urinary tract infection and association between virulence expression and antimicrobial susceptibility