Implication of Proteus spp in the Pathology of Nosocomial Wound Infection in Northeastern Nigeria

Abstract

Aims: To determine the infection rate and antibiogram of Proteus spp among hospitalised patients suffering from wound infection in Maiduguri. 
 Methodology: A total of 320 wound swab samples were collected from August 2016 to June 2017, and processed via microscopy, culture and further confirmed by biochemical tests. Kirby bauer disc diffusion test was used to determine the antimicrobial susceptibility pattern of Proteus spp isolated.
 Results: Twenty eight (28) samples yielded Proteus spp, giving a prevalence rate of 8.75%. Male patients were more affected (60.71%) compared to females (39.29%). Difference in sex in relation to rate of infection was statistically not significant (X2 =3.963, p<.01). Patients within the age group of 21-30 years (28.57%) recorded the highest bacterial yield while those of 61-70 years and >70 years (3.57% respectively) recorded the least. Patients suffering from Wound Sepsis and Burns recorded the most significant infection rate (28.57% respectively). Proteus mirabilis (53.57%) was the most isolated Proteus specie while Proteus penneri (7.14%) was the least. Proteus spp isolates demonstrated a marked resistance against Augmentin (89.29%) and Nalidixic Acid (85.71%) but high sensitivity was observed towards Ciprofloxacin (85.71%) and Streptomycin (78.57%).
 Conclusion: We establish that Proteus spp actually contribute to the pathology of wounds infection among hospitalised patients, and the Proteus specie most implicated in the aetiology of wound infection is Proteus mirabilis. Ciprofloxacin and Streptomycin are the drugs of choice for the treatment of patients with Proteus spp wound infection in the study area, and the use of Nalidixic acid and Augmentin is highly discouraged due to high resistance.

A Concurrent Extended Spectrum Beta-lactamase Production and Multidrug Resistance among Proteus Species isolated from Clinical samples of patients attending selected Hospitals in North Eastern Nigeria.

“…The Resistance mechanisms encompass various factors, one of the most crucial being the production of enzymes encoded by specific genes carried on bacterial plasmids, including β-lactamase and extended-spectrum β-lactamase. The prevalence of MDR bacterial strains producing extended-spectrum beta-lactamase (ESBL) has been on the rise in recent years, particularly affecting the prognosis and survival of hospitalized patients in developing countries such as Nigeria (Senthamarai et al, 2015;Tom et al, 2018). Extended-spectrum β-lactamases (ESBLs) have emerged as a significant resistance mechanism against cephalosporins and other β-lactam antibiotics, primarily in Gram-negative bacteria, especially those of the Enterobacteriaceae family such as Klebsiella pneumoniae, Escherichia coli, Proteus spp (Mendelson et al, 2005;Paterson and Bonomo, 2005;Falagas and Karageorgopoulos, 2009), and other bacterial species such as Acinetobacter baumannii and Pseudomonas aeruginosa (Jacoby and Munoz-Price, 2005).…”

“…They are generally derived from Temorina (TEM) and sulfhydryl variable (SHV) type enzymes (Lautenbach et al, 2001). Proteus species, like many other members of the Enterobacteriaceae family, can harbor numerous plasmids and integrons housing genetic determinants of antimicrobial resistance (Tom et al, 2018). Different kinds of infectious diseases such as cystitis, pyelonephritis, prostatitis, chronic otitis media, eye infections, respiratory tract infections (RTI), wound infections, burn infections, and bloodstream infections are in some cases linked to pathogenic Proteus (Stock, 2003).…”