Molecular screening of antibiotic-resistant determinants among multidrug-resistant clinical isolates of <i>Proteus mirabilis</i> from SouthWest Nigeria

Abstract

Background: Globally, and particularly in developing countries, the menace of anti-microbial resistance is an accelerating problem. In Nigeria, increase in bacterial resistance has been phenotypically established but due to high cost, few molecular studies have been reported. Objectives: This study screened for presence of transferable resistance genes and mobile genetic elements (MGEs) such as integron among multi-drug resistant (MDR) P. mirabilis. Methods: A total of 108 P. mirabilis strains collected from five tertiary hospitals in SouthWest Nigeria were subjected to antibiotic susceptibility study using disc-diffusion method. Transferable resistance genes and MGEs were amplified using Polymerase chain reaction (PCR) analysis and amplicons sequenced. Results: Varied resistance was observed against all the antibiotics tested. About 56% of the isolates were MDR including those from 0-12 years old children. PCR analysis revealed the presence of aac(6')-Ib (33.3%), plasmid mediated quinolone resistance (PMQR) genes [qnrA (36.7%), acc(6')-Ib-cr (5%)], TEM (48.3%), CTX-M (6.7%) and integrons class 1 (58.3%) and class 2 (26.7%). Sequencing analysis revealed bla TEM-1 , bla CTX-M-15 associated with ISEcp1 and eight different arrays of gene cassettes: aadA1, aadA1-qacH, aadB-aadA2, aadA5, dfrA7, dfrA15, dfrA17, dfrA17-aadA5. Conclusion: Transferable resistance genes in association with MGEs are present in Nigerian P. mirabilis thus their potential in disseminating resistance.

Assessment of Pathogenic Potential, Virulent Genes Profile, and Antibiotic Susceptibility of Proteus mirabilis from Urinary Tract Infection

“…On the contrary, the highest sensitivity was against ceftriaxone (96.8%), norfloxacin (82.5%), gentamicin (71.4%), and ciprofloxacin (69.8%). Similar results have been reported for P. mirabilis from Nigeria, where isolates' resistance rates to ciprofloxacin, nalidixic acid, sulfamethoxazole, and gentamicin were 13.9%, 53.7%, 74.1%, and 26.9%, respectively [21]. In Czech Republic, the isolates had a resistance rate of ciprofloxacin (35.2%), sulfamethoxazole (39.0%), ampicillin (38.5%), and gentamicin (25.4%), which are different form findings of the present study [22].…”

<p>Characterization of Antibiotic-Susceptibility Patterns, Virulence Factor Profiles and Clonal Relatedness in <em>Proteus mirabilis</em> Isolates from Patients with Urinary Tract Infection in Iran</p>

“…47 In another study in Nigeria, aac(6ʹ)-Ib-cr and qnrA genes were detected in 3 (5%) and 22 (36.7%) of the MDR P. mirabilis isolates, respectively, while none was positive for qepA. 48 According to the PFGE analysis, most of the isolates were clonally unrelated, and only four pulsotypes with more than one isolate were defined. Pulsotype 4 was related to 2 identical isolates (100% similarity) from different wards at the same hospital that maybe alarming for the dissemination of these isolates in different wards in a hospital.…”

Genetics of Acquired Antibiotic Resistance Genes in Proteus spp.

“…In 2017, this rate was significantly higher in Nigeria where qnrA and aac(6 )-Ib-cr were detected in, respectively, 36.7 and 5% of the 108 multidrug resistant P. mirabilis tested. These genes were most often carried associated with β-lactamase genes (bla TEM or bla CTX−M ) on class 1 and class 2 integrons (Alabi et al, 2017). It was observed that the qnrB10 and aac(6 )-Ib-cr genes were significantly associated with the ESBL genes whereas this is not the case for the qnrB19 nor qnrD (Albornoz et al, 2014).…”