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Multidrug-resistant Proteus rettgeri: an emerging problem

P B Iannini, T C Eickhoff, F M LaForce

    Annals of Internal Medicine
    |August 1, 1976
    PubMed

    Insights

    Multidrug-resistant Proteus rettgeri infections primarily affect the urinary tract, especially in neurology patients. Rising resistance to common antibiotics necessitates exploring alternatives like amikacin and cefoxitin.

    Area of Science:

    • Medical Microbiology
    • Infectious Diseases
    • Hospital Epidemiology

    Background:

    • Proteus rettgeri is an opportunistic pathogen.
    • The emergence of multidrug-resistant (MDR) strains poses a significant clinical challenge.
    • Urinary tract infections (UTIs) are common hospital-acquired infections.

    Purpose of the Study:

    • To review a 6-year period of Proteus rettgeri infections.
    • To identify risk factors and trends associated with P. rettgeri UTIs.
    • To assess antimicrobial resistance patterns of P. rettgeri.

    Main Methods:

    • Retrospective review of P. rettgeri infections over six years.
    • Comparison of UTI patients with a control group to identify risk factors.
    • Antimicrobial susceptibility testing using disc diffusion.

    Main Results:

    • Ninety percent of infections were UTIs, with 50% occurring on a neurology ward.
    • Increased hospitalization, Foley catheter use, prior antibiotic exposure, and paraplegia were linked to P. rettgeri UTIs.
    • Progressive resistance to kanamycin, streptomycin, ampicillin, and gentamicin was observed.
    • Recent isolates showed high resistance to common antibiotics but susceptibility to amikacin, cefoxitin, and ticarcillin.

    Conclusions:

    • Proteus rettgeri poses a growing threat, particularly for hospitalized neurology patients.
    • Risk factors for P. rettgeri UTIs include prolonged hospitalization and indwelling devices.
    • Emerging MDR strains necessitate careful antibiotic stewardship and consideration of alternative agents.

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