Assessment of Pathogenic Potential, Virulent Genes Profile, and Antibiotic Susceptibility of Proteus mirabilis from Urinary Tract Infection.

Emad I Hussein,Fatina W Dahadhah,Khalid Al-Batayneh,Karem H Alzoubi,Majed M Masadeh,Mazhar Salim Al Zoubi,Alaa A Aljabali

doi:10.1155/2020/1231807

Abstract

Proteus mirabilis is the third most common bacterium that can cause complicated UTI, especially in catheterized patients. Urovirulence genes of P. mirabilis strains are poorly identified among UTI patients. The aims of the present study were to determine the prevalence of the uropathogenic P. mirabilis strains isolated from UTI patients by the detection of several P. mirabilis virulence genes and to characterize the antibiotic susceptibility profile of P. mirabilis isolates. P. mirabilis isolates were collected from urine specimens of patients suffering from UTI. Virulence genes in P. mirabilis, namely, hpmA, hpmB, rsbA, luxS, ureC1, hlyA, rpoA, atfA, atfC, mrpA, and pm1 were detected in the isolates via PCR detection method. All P. mirabilis virulence genes were detected in more than 90% of the isolates except hlyA gene, which was detected in only 23.8% of the isolates. The rate of susceptibility for ceftriaxone was 96.8%, followed by norfloxacin (82.5%), gentamicin (71.4%), ciprofloxacin (69.8%), cephalexin (52.4%), nalidixic acid (42.9%), sulfamethoxazole (39.7%), ampicillin (36.5%), and nitrofurantoin (3.2%). Significant associations (P < 0.05) were detected between antimicrobial susceptibility of each of the following antibiotics and the presence virulence genes. Cephalexin antimicrobial susceptibility was significantly associated with the presence each of ureC1 and atfC. Sulfamethoxazole antimicrobial susceptibility was significantly associated with the presence atfA. Ceftriaxone antimicrobial susceptibility was significantly associated with the presence each of hpmA, ureC1, rpoA, atfC, mrpA, and pm1. Nitrofurantoin antimicrobial susceptibility was significantly associated with the presence each of hpmA, ureC1, rpoA, atfA, atfC, mrpA, and pm1. In conclusion, an association between the presence of urovirulence genes of P. mirabilis and increasing P. mirabilis resistance to antimicrobials has been demonstrated.

Highlights

Proteus mirabilis is one of the most common Gramnegative bacteria that can cause UTIs
Antimicrobial Susceptibility Results. e antimicrobial susceptibility results of the P. mirabilis isolates to several antimicrobial agents are shown in Table 1, which represents results as susceptible, intermediate, and resistant. e rate of antibiotic resistance was highest for nitrofurantoin (88.9%), whereas it was lowest for ceftriaxone (1.6%)
Detected rates of virulence genes are shown in Table 2. e antimicrobial susceptibility was highly correlated with the presence of P. mirabilis virulence genes (Table 3)

Summary

Introduction

Proteus mirabilis is one of the most common Gramnegative bacteria that can cause UTIs. Bacteriuria, kidney stones, catheter obstruction, acute pyelonephritis, and fever can be developed by P. mirabilis [1]. P. mirabilis is becoming resistant to antibiotics commonly used in the treatment of UTI [2]. P. mirabilis encodes many virulence genes involved in infection [4, 5]. Urease (ureC1) is a virulence gene that is important in P. mirabilis pathogenesis. Is enzyme catalyzes the kidney and bladder stone formation or blocks indwelling urinary catheters [6]. Urease is required for urolithiasis, where it contributes in hydrolyzing urea to release ammonia, thereby increasing urinary pH, resulting in precipitation of calcium and magnesium compounds, and urinary stone formation [7]

Objectives

Methods

Results

Conclusion