Prevalence of extended-spectrum β-lactamases, AmpC, and carbapenemases in Proteus mirabilis clinical isolates

Abstract

Background Proteus mirabilis is an opportunistic pathogen, causing a variety of community-acquired and nosocomial illnesses. It poses a potential threat to patients via the production of β-lactamases, which decrease the efficacy of antimicrobial treatment and impair the management of its pathogenicity. Hence, this study was established to determine the prevalence of extended-spectrum β-lactamases (ESBLs), AmpC, and carbapenemases of P. mirabilis isolated from various clinical specimens. Results Proteus mirabilis was identified in 20.7% (58/280) of specimens. ESBL producers were present at a rate of 51.7% (30/58). All AmpC-positive isolates (n = 20) produced ESBLs as well, so 66.7% of ESBL-producing isolates coproduced AmpC enzymes. The modified Hodge test confirmed carbapenemase production in six out of seven imipenem nonsusceptible isolates. Of these, only two (5.7%) isolates were also ESBL-and AmpC-positive. Antibiotic resistance reached the highest level for cotrimoxazole (62.1%, n = 36/58 isolates) and the lowest for imipenem (12.1%, n = 7/58 isolates). The levels of multidrug-resistant (MDR) was 41.4% among the tested isolates. The blaSHV (83.3%), blaAmpC (80%), and blaVIM-1 (50%) were the most detected genes in phenotypically confirmed ESBL-, AmpC-, and carbapenemase-producing isolates, respectively. Besides, more than a half of the tested P. mirabilis strains (53%) coproduced ESBLs and AmpC. Moreover, two isolates coproduced ESBLs and AmpC together with carbapenemases. Furthermore, dendrogram analysis showed great genetic divergence based on the 21 different enterobacterial repetitive intergenic consensus (ERIC) patterns (P1–P21) through the 34 β-lactamase producers. ERIC analysis distinguished clonal similarities between isolates 21 and 22 in P2 and 9 and 10 in P4, which were isolated from the same clinical source and possessed similar patterns of β-lactamase-encoding genes. Conclusion Hence, there is an urgent need to monitor hospitalized patients and improve healthcare in order to reduce the incidence of infection and outbreaks of infection with antibiotic-resistant Proteus.

Antibiotic resistance and virulence profiles of Proteus mirabilis isolated from broiler chickens at abattoir in South Africa

“…Among our isolates, bla CTX‐M , bla TEM and bla CTX‐M‐2 were the most commonly detected ESBL genotypes. This agrees with other studies conducted in Korea, Italy and Brazil that reported the presence of genes from P. mirabilis (Ahn et al., 2017 ; Luzzaro et al., 2001 ; Sanches et al., 2023 ) but differs with the study conducted in Egypt (Shaaban et al., 2022 ), where the bla SHV , bla ampC and bla VIM‐1 were the most detected genes. Multiple ESBL resistance genes may impart resistance to β‐lactamases regardless of reduced expression of one or more of those genes (Gundran et al., 2019 ).…”

Antimicrobial Susceptibility Trends of Proteeae Isolates From a Tertiary-Care Hospital in Western Saudi Arabia

“…Our findings are fairly parallel to the results from a previous Nigerian study, where 21% of the investigated Proteeae were confirmed phenotypically to be ESBL producers [19]. Amongst our P. mirabilis isolates, the rate of ESBL production is considerably lower than that from a recent report from Egypt [20]. On the other side, 21.6% of the recovered Providencia species isolates (n=8) produced ESBLs, compared to 52% from an Italian university hospital [21].…”

“…Almost half of the MDR P. mirabilis isolates (50.8%; 30/59) were obtained from urine samples. This result specifies that P. mirabilis has a greater predisposition for colonizing the urinary tract and exerting resistance to various antibiotics [20]. A recent single-centered, observational, retrospective study from Saudi Arabia reported a lower rate of MDR amongst Proteus species (12.5%).…”

Occurrence of Carbapenemases, Extended-Spectrum Beta-Lactamases and AmpCs among Beta-Lactamase-Producing Gram-Negative Bacteria from Clinical Sources in Accra, Ghana

“…The finding of greater proportions of AmpC-producing GNB being MDRs was expected since the presence of AmpC β-lactamases is accompanied with resistance to first to third-generation cephalosporins, including cephymacins. It is known that AmpC enzymes may disguise the true effect of ESBLs and their identification in a bacteria strain, thus complicating the treatment of infections caused by bacteria co-harboring both genes [ 38 ]. In this study, E. coli co-harbored AmpC and ESBL ( bla TEM and bla DHA-M ) genes; likewise, K. pneumoniae co-harbored AmpC and carbapenemase genes (( bla FOX-M + bla EBC-M ) + ( bla KPC + bla OXA- 48 ) ), which has also been observed in studies in Egypt [ 38 ] and Nigeria [ 39 ].…”