Virulence genes and antimicrobial resistance pattern in Proteus mirabilis strains isolated from patients attended with urinary infections to Tertiary Hospitals, in Iran.

Azardokht Tabatabaei,Khadijeh Ahmadi,Nastaran Khosravi,Alireza Namazi Shabestari,Ali Badamchi

doi:10.4314/ahs.v21i4.22

Abstract

Proteus mirabilis is a frequent reason for catheter-associated urinary tract infections (UTIs). The aim of this study was to identify virulence genes and antimicrobial resistance patterns in P. mirabilis strains isolated from patients who attended a tertiary hospital in Iran. In this study, 100 P. mirabilis strains from urine samples were isolated. These isolated strains were identified by biochemical and PCR-based tests, and their antibiotic resistance was profiled through a standard procedure using 14 antibiotics. PCR assays were used to detect virulence-related genes in P. mirabilis strains. The biofilm formation of each P. mirabilis strain was examined. Of the 100 P. mirabilis isolates, 16 (16%) were multidrug-resistant. High resistance was observed against cotrimoxazole (97%), nalidixic acid (93%), cefotaxime (77%), and amoxicillin (62%). Sixty of the 100 isolates showed resistance against extended-spectrum cephalosporins. The prevalence rates of the genes related to the virulence factors in this study were mrpH (100%), ucaA (91%), hpmA (94%), zapA (95%), ptaA (100%), ureG (100%), pmfA (100%), fliC (97%), and mrpA (90%) using PCR method. Strong biofilm formation was observed in 20% (5/25) of the strains isolated from non-catheterized samples and 80% (20/25) of strains isolated from catheterized samples. Resistance to antibiotics and the prevalence of pathogenicity genes are high in Proteus mirabilis strains iolated from UTIs.

Highlights

Proteus mirabilis is a frequent reason for catheter-associated urinary tract infections (UTIs)
Strong biofilm formation was observed in 20% (5/25) of the strains isolated from non-catheterized samples and 80% (20/25) of strains isolated from catheterized samples
Isolation of P. mirabilis A total of 100 specimens representing patients clinically were diagnosed as UTI patients distributed as 40 Isolates from males and 60 Isolates from females. 35 (35%) strains were isolated from urine collected from catheterized, while 65 (65%) strains were isolated from the urine of non-catheterized patients

Summary

Introduction

Proteus mirabilis is a frequent reason for catheter-associated urinary tract infections (UTIs). The aim of this study was to identify virulence genes and antimicrobial resistance patterns in P. mirabilis strains isolated from patients who attended a tertiary hospital in Iran. Methods: In this study, 100 P. mirabilis strains from urine samples were isolated. These isolated strains were identified by biochemical and PCR-based tests, and their antibiotic resistance was profiled through a standard procedure using 14 antibiotics. Virulence genes and antimicrobial resistance pattern in Proteus mirabilis strains isolated from patients attended with urinary infections to Tertiary Hospitals, in Iran. Health Sciences License (https://creativecommons.org/licenses/BY/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Three potential toxins have been characterized for their important role in virulence These are hemolysin, Proteus toxic agglutinin (pta), and ZapA metalloprotease. Zap protease and hemolysin may cause swarm cells to be more cytotoxic to the host urothelium[5]

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