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Infection caused by Proteus mirabilis strains with transferrable gentamicin-resistance factors
Abstract:
During a period of 10 weeks, four patients in one hospital became infected with gentamicin-resistant Proteus mirabilis. In two of them septicaemia associated with indwelling catheters developed, one had urinary tract and wound infections, and in the fourth patient the organism was isolated from a superficial wound. The P. mirabilis strains showed multiple drug resistance. Strains form the first three patients were apparently identical and were sensitive to tobramycin. Their gentamicin resistance was not transferable to Escherichia coli K12, but could be transferred to another strain of P. mirablilis (PM13-3). The fourth strain was resistant to tobramycin; its gentamicin/tobramycin resistance was transferable to E. coli K12.
Insights
Gentamicin-resistant Proteus mirabilis caused infections in four patients. Resistance mechanisms varied, with some strains transferable to E. coli, highlighting hospital-acquired infection risks.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Hospital-acquired infections pose significant challenges to patient care.
- Proteus mirabilis is an opportunistic pathogen frequently associated with healthcare settings.
- Emergence of multidrug-resistant strains necessitates understanding resistance mechanisms.
Purpose of the Study:
- To investigate the characteristics of gentamicin-resistant Proteus mirabilis infections in hospitalized patients.
- To determine the genetic basis and transferability of antimicrobial resistance in these strains.
- To identify potential sources and transmission routes of resistant bacteria within the hospital environment.
Main Methods:
- Isolation and identification of Proteus mirabilis from infected patients.
- Antimicrobial susceptibility testing, including resistance to gentamicin and tobramycin.
- Plasmid analysis and conjugation experiments to assess the transferability of resistance genes to Escherichia coli K12 and other P. mirabilis strains.
Main Results:
- Four patients acquired gentamicin-resistant Proteus mirabilis infections over 10 weeks.
- Infections included septicaemia, urinary tract, and wound infections.
- Two distinct resistance profiles were observed: one transferable to P. mirabilis only, the other transferable to E. coli.
Conclusions:
- Hospitalized patients are susceptible to multidrug-resistant Proteus mirabilis.
- Different gentamicin resistance mechanisms exist, with varying transferability potential.
- Understanding resistance transfer is crucial for controlling hospital-acquired infections.