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Multidrug-Resistant Proteus mirabilis Infections and Clinical Outcome at Tertiary Hospital in Riyadh, Saudi Arabia

Taghreed A Hafiz1, Ghadi S Alghamdi1, Zeina S Alkudmani1

  • 1Clinical Laboratory Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, 12372, Saudi Arabia.

Infection and Drug Resistance
|February 20, 2024
PubMed
Abstract

Insights

Proteus mirabilis infections pose a significant threat to hospitalized patients, particularly in ICUs. This study highlights antimicrobial resistance patterns and identifies risk factors for mortality in Saudi Arabia.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Proteus mirabilis is a common cause of hospital-acquired infections, especially urinary tract infections.
  • It poses a significant threat to hospitalized patients, particularly those with invasive devices in long-stay units.
  • Limited data exists on P. mirabilis epidemiology and antimicrobial resistance in Saudi Arabia.

Purpose of the Study:

  • To investigate the epidemiological patterns of P. mirabilis infections in Saudi Arabia.
  • To characterize antimicrobial resistance profiles of P. mirabilis isolates.
  • To determine clinical outcomes and risk factors for mortality in P. mirabilis-infected patients.

Main Methods:

  • Retrospective analysis of 598 P. mirabilis isolates from King Fahad Medical City, Riyadh (2019-2021).
  • Inclusion of clinical data from 78 intensive care unit (ICU) patients.
  • Identification and antimicrobial susceptibility testing using the Phoenix BD instrument; statistical analysis of demographic, clinical, and outcome data.

Main Results:

  • Pan-drug-resistant P. mirabilis identified in 2019; multi- and extensively drug-resistant isolates were most frequent that year.
  • Highest susceptibility observed for piperacillin-tazobactam, carbapenems, and cephalosporins; lowest for cephalothin, trimethoprim-sulfamethoxazole, and ampicillin.
  • Urine infections were more common in females and non-ICU patients (p <0.001); respiratory infections were higher in ICU patients (p <0.001). ICU patients on renal dialysis had a 7.2-fold higher risk of death (P=0.034).

Conclusions:

  • Proteus mirabilis infections can lead to severe outcomes in hospitalized patients.
  • Understanding local epidemiology and resistance patterns is crucial for effective management.
  • Further research is needed to fully assess the severity and implement preventive strategies.
Keywords:
ICUProteus mirabilisextensively drug-resistantmortalitymultidrug-resistantnosocomial infectionpan-drug-resistantrisk factors

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