Molecular Detection of Beta-lactamase Genes in Proteus Species Isolated From Urinary Tract Infections in a Pakistani Hospital

Abstract

Antimicrobial resistance in Proteus species (spp)is increasing, such as the resistance to cephalosporins due to the production of extended-spectrum β-lactamases (ESBL) genes in hospitalized patients, which is a matter of great concern.For this purpose, 150 Proteus spp.isolates were collected from urinary tract infection (UTI) patientsby standard microbiological procedures.Phenotypic detection of ESBLs, MBLs, and pAmpC was conducted by combined disk diffusion and Double Disk Synergy Test (DDST). Conventional PCR was done forureCand NDM-1, while ESBLs, MBLs, and pAmpC genes were screened through multiplex PCR.Of the total, 50 were confirmed as Proteus spp. (Proteus mirabilis (46) and Proteus vulgaris(4)).All isolates displayedβ-lactam resistance. The highest resistance was examined against Erythromycin (80%) and Rifampicin (72%), while resistance towards Levofloxacin and Imipenem was noticed as 60% and 58% respectively. Detection of ESBLs, MBLs, pAmpC, and NDM-1 were recorded as 48%, 28%, 36%,and 56% respectively.This is probably the first report from Pakistan reporting the high prevalence of β-lactamase genes in Proteus spp. of hospital origin. The current status of multidrug resistance(MDR) and increase in β-lactamase production in Proteus spp.in a Pakistani hospital is very alarming for healthcare workers.