Prevalence, Antibiotic Susceptibility Pattern and Detection of Transferable Resistant Genes in Proteus Species from Urinary Tract Infections in a Tertiary Hospital in South-East of Nigeria : Transferable Resistant Genes in Proteus Species

Orjioke Nkemdilim Nwaka; Onyemelukwe Ngozi Franca

doi:10.54393/pjhs.v4i12.1183

Authors

Orjioke Nkemdilim Nwaka Department of Medical Laboratory Sciences, University of Nigeria, Enugu Campus, Nsukka, Nigeria
Onyemelukwe Ngozi Franca Department of Medical Laboratory Sciences, University of Nigeria, Enugu Campus, Nsukka, Nigeria

DOI:

https://doi.org/10.54393/pjhs.v4i12.1183

Keywords:

Proteus species, antibiotic susceptibility, urinary tract infections, multidrug resistant, extended spectrum beta-lactamases, transferable resistant genes

Abstract

Drug-resistant Proteus species cause global public health threats, including in Nigeria, due to antibiotic resistance. Objective: To determine the prevalence, antibiotic susceptibility, and detection of resistant genes in Proteus species causing UTIs in a Nigerian hospital. Methods: A cross-sectional study was conducted over seven months at Alex-Ekwueme Federal University Teaching Hospital in Abakaliki, Ebonyi State, Nigeria. The study included 650 urine samples from male and female in-patients and out-patients displaying UTI symptoms. Disc diffusion method was used for antimicrobial susceptibility testing and double disc-synergy test was employed to check for the presence of extended spectrum beta-lactamases. Polymerase chain reaction (PCR) was utilized to screen for transferable resistant genes and mobile genetic elements. Results: Out of 650 urine samples, 84 (12.9%) Proteus species isolates were identified. 60 (71.4%) were Proteus mirabilis and 24 (28.6%) were Proteus vulgaris. Females had a higher distribution of isolates (76.2%) compared to males (23.8%) (p=0.010). Age group showed higher isolates in the 31-40 (23.8%) and 41-50 (22.6%) age groups (p<0.001). No significant association was found between Proteus species and urine types or patient categories (p=0.061 and p=1.000, respectively). Levofloxacin and ceftazidime exhibited the greatest effectiveness, while nalidixic acid, imipenem, and nitrofurantoin displayed the highest resistance against Proteus species. 56% of Proteus isolates were multidrug resistant. PCR analysis detected TEM (23.1%), CTX-M (23.1%), SHV (15.4%), aab(61)-1b (10.3%), qnrB (2.6%), and class 1 integrase gene (25.7%). Conclusions: Proteus isolates carry transferable resistant genes associated with class 1 integrase.

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