Distribution of blaTEM, blaSHV, blaCTX-M, blaOXA, and blaDHA in Proteus mirabilis Isolated from Diabetic Foot Infections in Erbil, Iraq

Abstract

Diabetic foot infection is considered to be one of the most important medical, economic, and social problems and a major cause of morbidity and mortality. Proteus mirabilis is a common etiologic agent of diabetic foot infections. This study aimed to determine the prevalence of beta-lactamase genes in P. mirabilis recovered from patients with diabetic foot wounds in Erbil, Iraq. Eighteen P. mirabilis isolated from 84 patients with diabetic foot ulcers were first phenotypically examined for the existence of extended-spectrum beta-lactamases by combined disc method and double-disc synergy method that all isolates showed positive results by both methods. The results were confirmed genetically by PCR to detect beta-lactamase-encoding genes (bla TEM , bla SHV , bla CTX-M , bla OXA , and bla DHA ). The results revealed that all isolates contained extended-spectrum beta-lactamase and that 80% of the P. mirabilis isolates contained bla DHA , 60% had bla TEM , 53.3% had bla OXA , and 26.7% had bla CTX-M , whereas no isolates harbored bla SHV . The coexistence of two or more beta-lactamase genes in one isolate was observed. The existence of four genes (bla TEM + bla CTX-M + bla OXA + bla DHA ) in the same isolate was documented in two isolates. In conclusion, this is the first study that reports a high prevalence of bla DHA and the coexistence of four resistance genes in the same organism in P. mirabilis isolated from diabetic foot patients in Iraq.

The Healing Capability of Clove Flower Extract (CFE) in Streptozotocin-Induced (STZ-Induced) Diabetic Rat Wounds Infected with Multidrug Resistant Bacteria

“…A significant problem facing physicians in the treatment of diabetic foot ulcer (DFU) is the existence of multidrug-resistant (MDR) microbes, where many variants of MDR microbes have been isolated and characterized [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. MDR- P. mirabilis is one of the most prevalent microbes to exist in diabetic foot ulcers (DFU) [ 12 ]. There is a vast need to search for other innovative therapies based on using natural plant extract either singly or in combination with antibiotics [ 11 ], probiotics [ 3 , 13 , 14 , 15 , 16 , 17 ], natural and modified proteins [ 18 , 19 ], nanoparticles [ 20 ], and phage therapy [ 21 ].…”