Scholarlink

Background <p>Recent worldwide reports of increased numbers of multidrug-resistant (MDR) <i>Proteus mirabilis</i> (<i>P. mirabilis</i>) isolates, particularly those producing extended-spectrum β-lactamases (ESBLs), are alarming. <i>P. mirabilis</i> is a common causative agent of complicated urinary tract infections (UTIs), particularly in patients with long-term urinary catheterization. This study aimed to assess the prevalence, antibiotic resistance patterns, and determinants of <i>P. mirabilis</i> among catheter-associated UTIs (CAUTI) and non-catheter-associated UTIs (non-CAUTI).</p> Methods <p>One hundred and three <i>Proteus</i> strains isolated from 613 UTI patients in Minia, Egypt, were examined for antibiotic resistance patterns, ESBL production, and sulphonamide resistance phenotypically. Class 1 and 2 integrons, ESBL, and <i>sul</i> resistance genes were detected by Polymerase chain reaction (PCR), followed by molecular typing of ESBL-producing isolates from catheterized UTI patients using ERIC-PCR.</p> Results <p><i>Proteus</i> isolates were detected in 20% of the UTIs, with a higher rate among inpatients (27.3%) compared to outpatients (10.6%). <i>Proteus</i> was more significantly isolated from catheterized UTI patients (28.2%, 55/195) than from non-catheterized patients (14.9%, 48/321). Of the 103 <i>Proteus</i> isolates, 99 (96.1%) were identified as <i>P. mirabilis</i>. High resistance was observed against trimethoprim/sulfamethoxazole (SXT) (80.6%), amoxicillin-clavulanic (AMC) (57.3%), ceftazidime (55.3%), and imipenem (46.6%) antibiotics. Significantly higher resistance rates were observed among <i>Proteus</i> isolates from inpatients and catheterized patients. Of the 103 <i>Proteus</i> strains, 81 (78.6%) were MDR, with 70.9% of the isolates from catheterized patients. About 74.6% of the isolates from inpatients were MDR. <i>Sul</i> genes were detected in 77 isolates (74.7%). The frequency of ESBL-producing <i>Proteus</i> isolates was 37.9% which was significantly higher in catheterized patients with increasing dissemination of <i>bla</i><sub>TEM</sub> genes and <i>bla</i><sub>CTX-M</sub> genes. <i>Int1 and Int2</i> genes were detected in 92.2% and 68.9% of isolates, respectively. ERIC-PCR revealed moderate similarity (65%) between ESBL-producing <i>Proteus</i> isolates from catheterized patients.</p> Conclusion <p>The high frequency of MDR <i>P. mirabilis</i> strains isolated from UTIs in Egypt, particularly among catheterized patients, is a major concern, especially with disseminating class 1 and 2 integrons among isolates. The study also highlights the decreased susceptibility to sulphonamides, 3rd generation cephalosporins, and imipenem, commonly used to treat UTIs. Increased dissemination of ESBL-producing <i>Proteus</i> isolates among CAUTIs complicates their treatments. This important pathogen deserves more attention in the&#xa0;future for a better understanding of resistance mechanisms and the&#xa0;dissemination potential of resistant strains.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Characterization of antimicrobial resistance among Proteus mirabilis isolates from catheter-associated urinary tract infections and non-catheter-associated urinary tract infections in Egypt

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月27日

查看全文
  • Noha A. Hassuna,
  • Dalia N. Kotb,
  • Marina Lami,
  • Soha S. Abdelrahim

摘要

Background

Recent worldwide reports of increased numbers of multidrug-resistant (MDR) Proteus mirabilis (P. mirabilis) isolates, particularly those producing extended-spectrum β-lactamases (ESBLs), are alarming. P. mirabilis is a common causative agent of complicated urinary tract infections (UTIs), particularly in patients with long-term urinary catheterization. This study aimed to assess the prevalence, antibiotic resistance patterns, and determinants of P. mirabilis among catheter-associated UTIs (CAUTI) and non-catheter-associated UTIs (non-CAUTI).

Methods

One hundred and three Proteus strains isolated from 613 UTI patients in Minia, Egypt, were examined for antibiotic resistance patterns, ESBL production, and sulphonamide resistance phenotypically. Class 1 and 2 integrons, ESBL, and sul resistance genes were detected by Polymerase chain reaction (PCR), followed by molecular typing of ESBL-producing isolates from catheterized UTI patients using ERIC-PCR.

Results

Proteus isolates were detected in 20% of the UTIs, with a higher rate among inpatients (27.3%) compared to outpatients (10.6%). Proteus was more significantly isolated from catheterized UTI patients (28.2%, 55/195) than from non-catheterized patients (14.9%, 48/321). Of the 103 Proteus isolates, 99 (96.1%) were identified as P. mirabilis. High resistance was observed against trimethoprim/sulfamethoxazole (SXT) (80.6%), amoxicillin-clavulanic (AMC) (57.3%), ceftazidime (55.3%), and imipenem (46.6%) antibiotics. Significantly higher resistance rates were observed among Proteus isolates from inpatients and catheterized patients. Of the 103 Proteus strains, 81 (78.6%) were MDR, with 70.9% of the isolates from catheterized patients. About 74.6% of the isolates from inpatients were MDR. Sul genes were detected in 77 isolates (74.7%). The frequency of ESBL-producing Proteus isolates was 37.9% which was significantly higher in catheterized patients with increasing dissemination of blaTEM genes and blaCTX-M genes. Int1 and Int2 genes were detected in 92.2% and 68.9% of isolates, respectively. ERIC-PCR revealed moderate similarity (65%) between ESBL-producing Proteus isolates from catheterized patients.

Conclusion

The high frequency of MDR P. mirabilis strains isolated from UTIs in Egypt, particularly among catheterized patients, is a major concern, especially with disseminating class 1 and 2 integrons among isolates. The study also highlights the decreased susceptibility to sulphonamides, 3rd generation cephalosporins, and imipenem, commonly used to treat UTIs. Increased dissemination of ESBL-producing Proteus isolates among CAUTIs complicates their treatments. This important pathogen deserves more attention in the future for a better understanding of resistance mechanisms and the dissemination potential of resistant strains.