Prevalence and antibiotic resistance patterns of Proteus mirabilis isolated from catheter-associated urinary tract infection.

Abstract

The aim of this study was to determine the frequency of the bacterial agents that cause urinary tract infection in catheterized patients at Zagazig University Hospital and to assess the antimicrobial resistance pattern of Proteus mirabilis isolates against various antimicrobial agents used for treating urinary tract infections in the spate of its recorded increasing resistance patterns.Urine specimens were obtained from catherized patients suffering from a urinary tract infection (UTI). The different isolates obtained were identified by conventional microbiological methods.The antibiotic susceptibility profile of Proteus mirabilis isolates was determined by agar dilution method. Patient's medical records showed significant increase in incidence of catheter associated urinary tract infection (CA-UTI) upon prolonged catheterization, among immunocompromised patients and patients with concomitant chronic diseases, elderly patients and female gender. The frequency of the obtained isolates was Eschersheia coli (33%), Klebsiella pneumoniae (14%), Enterococcus faecalis (13%), Proteus species (10.2%), Pseudomonas aeruginosa (10%), Staphylococcus aureus (10 %) and unidentified gram positive cocci (9.8%). 90% of the Proteus isolates were Proteus mirabilis. The resistance of P. mirabilis isolates were highest against Nalidixic acid, Ampicillin/Sulbactam, Amoxicillin/clavulanic acid, ceftazidime and cefuroxime (95.5%-57.8%). Lower resistance rates of P. mirabilis were found against amikacin, levoflxacin, ciporofloxacin and gentamicin (2.2 % -17.8 %). While P.mirabilis isolates were 100% sensitive to Imipenem. In conclusion, Imipenem is recommended to be used as an empirical treatment of CA-UTI caused by P. mirabilis.