Research Journal of Pharmacy and Technology

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Antimicrobial Resistance Patterns of Proteus mirabilis Isolates from Urinary Tract, Burn Wound and Diabetic Foot Infections


Affiliations
1 Zagazig, Zagazig University, Department of Microbiology and Immunology, Egypt
     

   Subscribe/Renew Journal


Proteus mirabilis is a common etiologic agent of urinary tract, burn wound and diabetic foot infections. Resistance to Proteus mirabilis is also common and represents a challenge to antibiotic therapy. This study aimed to investigate the antibiotic resistance of Proteus mirabilis isolated from three sources; urinary tract infections, burn wound infections in addition to diabetic foot infections. Forty-five clinical isolates of Proteus mirabilis (15 from each source) were used in this study. Complete resistance was found with each of ampicillin and tetracycline. High resistance was exhibited with cefepime. The resistance was intermediate against ceftazidime, cefotaxime, sulfamethoxazole-trimethoprim, amoxicillin-clavulinic, chloramphenicol, cefoperazone, aztreonam and ampicillin-sulbactam. Low resistance was found with piperacillin. These low resistance rates were also shown against tested aminoglycosides and fluoroquinolones. Very little resistance was found to imipenem, while no resistance was exhibited against piperacillin- tazobactam. The resistance pattern showed variation among different sources. Generally, burn wound isolates showed the highest resistance rates followed by diabetic foot isolates, while urinary tract isolates were the least resistant. High resistance was found with cefepime only in isolates from urinary tract infections and no diabetic foot isolate was highly resistant to any of the tested antibiotics. However, such resistance was observed with amoxicillin-clavulinic acid, cefepime, ceftazidime, cefotaxime and sulphamethoxazole-trimethoprim in burn wound isolates. Multidrug resistance (MDR) was also found with varying rates in isolates from different sources. MDR was more common in burn wound isolates than in diabetic foot isolates or urinary tract isolates. This study suggests that there is a variation in antibiotic resistance of Proteus mirabilis among different sources and alarms against high resistance especially in burn wound isolates that requires a strict policy in antibiotic dispensing to minimize such tesistance.

Keywords

Proteus mirabilis, Burn Infection, Urinary Tract Infection, Diabetic Foot Infection, Antibiotic Resistance.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Rozalski A, Sidorczyk Z and Kotelko K. Potential Virulence Factors of Proteus Bacilli. Microbiology and Molecular Biology Reviews. 61; 1997: 65-89.

  • O'Hara CM, Brenner FW and Miller JM. Classification, Identification and Clinical Significance of Proteus, Providencia, and Morganella. Clinical Microbiology Reviews. 13(4); 2000: 534–546.

  • Warren JW et al. A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. Journal of Infectious Diseases.146; 1982:719–723.

  • Warren JW. Catheter-associated urinary tract infections. Infectious Disease Clinicsof North America. 1(4); 1987:823-854.

  • Jacobsen SM et al. Complicated Catheter-Associated Urinary Tract Infections Due to Escherichia coli and Proteus mirabilis. Clinical Microbiology Reviews. 21(1); 2008: 26-59.

  • Shanmugam P, Jeya M and Linda Susan S. The Bacteriology of Diabetic Foot Ulcers, with a Special Reference to Multidrug Resistant Strain. Journal of Clinial and Diagnosti Research. 7(3); 2013: 441–445.

  • Church D et al. Burn Wound Infections. Clinical Microbiology Reviews. 13(4); (2000): 534–546.

  • Singh V. Antimicrobial resistance: In Microbial Pathogens and Strategies for Combating Them: Science, Technology and Education. Formatex Research Center. 2013, vol. 1: pp. 291–296.

  • Wright GD. Bacterial resistance to antibiotics: enzymatic degradation and modification. Advanced Drug Delivery Reviews. 57(10); 2005: 1451-1470.

  • Alekshun MN and Levy SB. Molecular Mechanisms of Antibacterial Multidrug Resistance. Cell. 128(6); 2007: 1037-1050.

  • Wilson DN. Ribosome-targeting antibiotics and mechanisms of bacterial resistance. Nature Reviews Microbiology. 12(1); 2014: 35-48.

  • Alanis AJ. Resistance to Antibiotics: Are We in the Post-Antibiotic Era? Archives of Medical Research. 36(6); 2005: 697-705.

  • Magiorakos AP et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical Microbiology and Infection. 18(3); 2012: 268-281.

  • Nikaido H. Multidrug resistance in bacteria. Annual Review of Biochemistry 78; 2009: 119–146.

  • Washington W Jr et al. Koneman's color atlas and textbook of diagnostic microbiology. Philadelphia: Lippincott Williams and Wilkins. 2005; 6thed.

  • Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing, 17th informational supplement. CLSI Document M100-S23. Wayne, USA, 2013.

  • Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically: Approvated standard, CLSI Document M07-A9. Wayne, USA, 2012.

  • Adler JL et al. Proteus infections in a general hospital. II. Some clinical and epidemiologic characteristic. With an analysis of 71 cases of Proteus bacteremia. Annals of InternalMediine. 75; 1971:531-536

  • Grahnquist L, Lundberg B and Tullus K. Neonatal Proteusmeningoencephalitis. Case report. ActaPathologicaMicrobiologicaEtImmunologicaScandinavica100; 1992:734-36.

  • Lu CH et al. Gram-negative bacillary meningitis in adult post-neurosurgical patients. Surgical Neurology. 52; 1999:438-443

  • Mordi RM and Momoh MI. Incidence of Proteus species in wound infections and their sensitivity pattern in the University of Benin Teaching Hospital. African Journal of Bacteriology.8(5); 2009: 725-30.

  • Manikandan C and Amsath I. Antibiotic susceptibility of bacterial strains isolated from wound infection patients in Pattukkottai, Tamilnadu, India. International Journal of Current Microbiology and Applied Scienes.2(6); 2013: 195-203.

  • Al-Ali KY. Microbial Profile of Burn Wound Infections in Burn Patients, Taif, Saudi Arabia.Archives of Clinical Microbiology. 7(2); 2016:15.

  • El-Tahawy AT. Bacteriology of diabetic foot Infections. Saudi Medical Journal.21 (4); 2000: 344-347.

  • Cunha MA et al. Antibiotic resistance patterns of urinary tract infections in a northeastern Brazilian capital. Revista do Instituto de Sao Medicina Tropical de Paulo. 58; 2016:2

  • Xavier W et al. Emergence of multi drug resistant bacteria in diabetic patients with lower limb wounds. Indian Journal of MedicalReserach. 140(3); 2014: 435–437.

  • Song CT. Burns infection profile of Singapore: prevalence of multidrug-resistant Acinetobacterbaumannii and the role of blood cultures. Burns and Trauma. 4; 2016:13


Abstract Views: 245

PDF Views: 0




  • Antimicrobial Resistance Patterns of Proteus mirabilis Isolates from Urinary Tract, Burn Wound and Diabetic Foot Infections

Abstract Views: 245  |  PDF Views: 0

Authors

Hisham A. Abbas
Zagazig, Zagazig University, Department of Microbiology and Immunology, Egypt
Mona A. El-Saysed
Zagazig, Zagazig University, Department of Microbiology and Immunology, Egypt
Amira M. Ganiny
Zagazig, Zagazig University, Department of Microbiology and Immunology, Egypt
Azza Abdel Fattah
Zagazig, Zagazig University, Department of Microbiology and Immunology, Egypt

Abstract


Proteus mirabilis is a common etiologic agent of urinary tract, burn wound and diabetic foot infections. Resistance to Proteus mirabilis is also common and represents a challenge to antibiotic therapy. This study aimed to investigate the antibiotic resistance of Proteus mirabilis isolated from three sources; urinary tract infections, burn wound infections in addition to diabetic foot infections. Forty-five clinical isolates of Proteus mirabilis (15 from each source) were used in this study. Complete resistance was found with each of ampicillin and tetracycline. High resistance was exhibited with cefepime. The resistance was intermediate against ceftazidime, cefotaxime, sulfamethoxazole-trimethoprim, amoxicillin-clavulinic, chloramphenicol, cefoperazone, aztreonam and ampicillin-sulbactam. Low resistance was found with piperacillin. These low resistance rates were also shown against tested aminoglycosides and fluoroquinolones. Very little resistance was found to imipenem, while no resistance was exhibited against piperacillin- tazobactam. The resistance pattern showed variation among different sources. Generally, burn wound isolates showed the highest resistance rates followed by diabetic foot isolates, while urinary tract isolates were the least resistant. High resistance was found with cefepime only in isolates from urinary tract infections and no diabetic foot isolate was highly resistant to any of the tested antibiotics. However, such resistance was observed with amoxicillin-clavulinic acid, cefepime, ceftazidime, cefotaxime and sulphamethoxazole-trimethoprim in burn wound isolates. Multidrug resistance (MDR) was also found with varying rates in isolates from different sources. MDR was more common in burn wound isolates than in diabetic foot isolates or urinary tract isolates. This study suggests that there is a variation in antibiotic resistance of Proteus mirabilis among different sources and alarms against high resistance especially in burn wound isolates that requires a strict policy in antibiotic dispensing to minimize such tesistance.

Keywords


Proteus mirabilis, Burn Infection, Urinary Tract Infection, Diabetic Foot Infection, Antibiotic Resistance.

References