The age of the source patients was known in 1110 patients. Of the 400 wound samples from various parts of the body 390 (97.5%) yielded growths and produced 560 isolates. 2000, 44: 1930-1935. PubMed  Treatment. J Clin Microbiol. Antimicrob Agents Chemother. Minimum inhibitory concentrations (MICs) were determined by the broth microdilution method following the guidelines of the manufacturer and Clinical and Laboratory Standards Institute (CLSI) [24]. Antimicrob Agents Chemother. PubMed  These isolates were also subjected to ESBL and/or AmpC β-lactamases gene detection by PCR. Kuo SC, Chang SC, Wang HY, Lai JF, Chen PC, Shiau YR, Huang IW, Lauderdale TL: Emergence of extensively drug-resistant Acinetobacter baumannii complex over 10 years: nationwide data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program. 2003, 15, 12–26 However, 79.6% of the 142 isolates were susceptible to ceftazidime (sensitivity, 20.4%; specificity, 99.7%; PPV, 68.8%; NPV, 90.0%) and 95.8% were susceptible to aztreonam (sensitivity, 4.2%; specificity, 99.5%; PPV, 75%; NPV, 88.2%). What antibiotic kills proteus mirabilis Download Here Free HealthCareMagic App to Ask a Doctor All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. Diagn Microbiol Infect Dis. The flagella allow the bacteria to swim around and, in some cases, actually swarm. Moreover, the connection between origin of the strains, biofilm maturity level, and resistance to antibiotics was proved. Proteus mirabilis belongs to the Enterobacteriaceae family with the features of swarming motility and production of urease to generate ammonia [1, 2]. J Microbiol Immunol Infect. Google Scholar. Article  2012, http://www.eucast.org/mic_distributions/ [Accessed 01.04.14]. Villar HE, Danel F, Livermore DM: Permeability to carbapenems of Proteus mirabilis mutants selected for resistance to imipenem or other β-lactams. The isolates were collected between July and September during the collection year and the collection process has been described previously [23]. Similar results have been found on P. mirabilis isolated from ICUs in Taiwan [21]. Eur J Clin Microbiol Infect Dis. Endimiani A, Luzzaro F, Brigante G, et al. The MIC distribution of cefazolin and imipenem are shown in Figure 2 to illustrate how the breakpoint change affected the susceptibility rate. CLSI documents M07-A09. 10.1128/AAC.00971-12. Rozalski A, Sidorczyk Z, Kotelko K: Potential virulence factors of Proteus bacilli. J. Chemother. Age (elderly vs. adult patients; OR, 2.22; 95% C.I., 1.06–4.62; P = 0.034) was also a sole factor significantly associated with AmpC β-lactamase gene carriage by both univariate and multivariate analyses. Wang, JT., Chen, PC., Chang, SC. Google Scholar. D’Andrea MM, Literacka E, Zioga A, Giani T, Baraniak A, Fiett J, Sadowy E, Tassios PT, Rossolini GM, Gniadkowski M, Miriagou V: Evolution and spread of a multidrug-resistant Proteus mirabilis clone with chromosomal AmpC-type cephalosporinases in Europe. Longitudinal nationwide data on antimicrobial susceptibility in Proteus mirabilis from different sources are rare. Proteus is widespread in the environment and makes up part of the normal flora of the human gastrointestinal tract. Clinical and Laboratory Standards Institute. Independent factors associated with the presence of ESBL genes were age (elderly patients) and location (ICU) of source patients. Early isolation of infected patients can also help to stop the spread of resistant bacteria. For example, susceptibility to β-lactam/β-lactamase inhibitors (ampicillin/sulbactam or amoxicillin/clavulanate), ciprofloxacin, and third generation cephalosporins (cefotaxime, ceftriaxone, or ceftazidime) ranged 74 to 94%, 60 to 90%, and 90 to 99%, respectively, depending on patient population and specimen type [12, 15–18]. "Motility is actually a really important factor in infection," said Nathalie Tufenkji, a chemi… 1995, 3: 280-284. [Google Scholar] Stock, I. Three to five colonies were lightly picked from fresh overnight culture plate to suspend in 150 μl AE buffer. Between 2002 and 2012, a total of 1157 P. mirabilis were studied. Antimicrob Agents Chemother. Proteus species accounted for 150 (26.8%) of the isolates. PubMed  This cookie is set by Advanced Ads and measures the browser width. PubMed  ‬ ‫النالدكسك‬ ‫حامض‬ ‫مضاد‬ ‫لعينات‬ ‫تعود‬ ‫التي‬ ‫أإلدرار‬ ، ‫مضاد‬ ‫من‬ ‫كل‬ ‫تجاه‬ ‫كانت‬ ‫مقاومة‬ ‫نسبة‬ ‫أعلى‬ ‫بان‬ ‫النتائج‬ ‫أظھرت‬ ‫وقد‬ ‫النايتروفورانتيون‬ 100 % ‫االمبسيلين‬ ‫مضاد‬ ‫تبعه‬ 75 % ‫ترايميثوبريم‬ ‫مضاد‬ ‫ثم‬ \ ‫سلفاميثازول‬ 65 %. TLL designed and supervised the study, participated in data analysis and interpretation, and finalized the manuscript. Most isolates were from inpatients (65.2%; 53.6% in general ward, and 11.6% in ICU). Isolates reported as P. mirabilis by hospitals were subcultured to blood agar and MacConkey agar plates for purity check and to confirm species identification at NHRI. Diagn Microbiol Infect Dis. Susceptibilities of isolates from different specimen types were mostly similar but outpatient isolates were more susceptible than inpatient isolates. Patients with UTI caused by P. mirabilis usually have alkaline pH urine due to the presence of ammonia resulting in calcium and magnesium crystallization which could in turn lead to obstruction of the lumen of indwelling catheters [4]. MIC distributions of cefazolin and imipenem in P. mirabilis. Sensititre custom-designed plates were used from 2002 to 2008, and the standard GNX2F plates were used in 2010 and 2012 [ThermoFisher Scientific (formerly Trek Diagnostics), East Grinstead, UK]. An MBE90 value of ciprofloxacin for isolates of P. vulgaris was 2 μg/mL and for P. mirabilis was 512 μg/mL. The large difference in imipenem susceptibility when using different breakpoints (2009 vs. current, 99.8% vs. 51.8%) is because of the high percentages of P. mirabilis isolates having imipenem MICs of either 2 or 4 mg/L, which were considered susceptible by the old criteria but intermediate and resistant, respectively, by the new criteria. 2013, 57: 2981-2988. There's more to see -- the rest of this entry is available only to subscribers. P. vulgaris usually resistant to ampicillin or cephalexin / cefazolin. In fact, among the 373 P. mirabilis isolates that had ertapenem, imipenem, and meropenem tested in our study, 76 had imipenem MIC of either 2 or 4 mg/L. The variable tested included β-lactam agents having old and revised CLSI breakpoints, and on isolates from different specimen types (blood, urine, pus/abscess, sputum) and patient locations [inpatients: intensive care units (ICU) or non-ICU, and outpatients]. In addition, the Clinical and Laboratory Standards Institute (CLSI) revised the interpretive criteria on several β-lactams for Enterobacteriaceae in recent years. Assessment the Impact of Tested Antibiotics on Proteus mirabilis Biofilm. Isolates were collected sequentially without specifying species to be collected. 10.1128/AAC.01736-10. ESBL (Extended spectrum beta-lactamase producing) Escherichia coli, Klebsiella pneumoniae CRE (Carapenem-resistant Enterobacteriaceae) Pseudomonas aeruginosa Neisseria meningitidis Neisseria gonorrhea Above the diaphragm (Peptostreptococcus) Below the diaphragm (Bacteroides sp) Taiwan is a mountainous island and the majority of the people live in the most densely populated western part (north, central and south regions) while the eastern part is the least populated region. Proteus mirabilis is a Gram-negative, facultative anaerobe bacilli, part of the Enterobacteriaceae family, with an ability to ferment maltose and inability to ferment lactose 1).Proteus mirabilis is well-known in clinical laboratories and microbiology survey courses as the species that swarms across agar surfaces, overtaking any other species present in the process. Chanal C, Bonnet R, De Champs C, Sirot D, Labia R, Sirot J: Prevalence of β-lactamases among 1,072 clinical strains of Proteus mirabilis: a 2-year survey in a French hospital. M100-S24. 1982, 146: 719-723. There were 172 isolates with ESBL phenotype (aztreonam, ceftazidime, and/or cefotaxime MICs ≥ 2 mg/L). In addition to being a leading cause of urinary tract infections (UTI), P. mirabilis can cause respiratory and wound infections, bacteremia, and other infections [1, 2]. Univariate and multivariate analyses were performed. The emergence and global spread of carbapenemase-producing Enterobacteriaceae (CPE) in recent years, especially isolates carrying genes encoding KPC (Klebsiella pneumoniae carbapenemase) and NDM (New Delhi metallo-β-lactamase) carbapenemases, have further compromised treatment options and added to the crisis of antimicrobial resistance [10, 11]. biofilm, and the impact of chosen sub-MIC concentrations of these antibiotics on biofilm at different stages of its formation. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2334/14/486/prepub. BMC Infect Dis 14, 486 (2014). However, using the 2014 UTI interpretive criteria for cefazolin, 81.2% of the urine isolates in our study were susceptible. The predominant ESBL and AmpC β-lactamase genes were CTX-M- and CMY- types, respectively. Treatment failure and clinical mortality are also more likely to occur in patients infected with ESBLs-producing P. mirabilis [9], which has been attributed to inadequate empirical therapy. The most common specimen type was urine, accounting for 49.4% (571), followed by pus/abscess (233, 20.1%), blood (158, 13.7%), sputum (133, 11.5%), and others (62, 5.4%). By multivariate analysis, age [elderly vs. adult patients; odds ratio (OR), 3.85; 95% confidence interval (95% C.I. Monstein HJ, Ostholm-Balkhed A, Nilsson MV, Nilsson M, Dornbusch K, Nilsson LE: Multiplex PCR amplification assay for the detection of bla Isolates were collected biennially between 2002 and 2012 (corresponding to TSAR III – VIII). Clin Microbiol Infect. statement and © 2021 BioMed Central Ltd unless otherwise stated. Conclusions: Proteus mirabilis is one of the important causative agents of urinary tract infection in young women especially during the state of pregnancy. can have naturally higher imipenem MICs [19, 20]. Molecular screening of antibiotic-resistant determinants among multidrug-resistant clinical isolates of Proteus mirabilis from SouthWest Nigeria Afr Health Sci . All tested strains formed a biofilm. Proteus mirabilis is commonly encountered in water and soil. CAS  Tsai-Ling Yang Lauderdale. [14]. There are certain antibiotic drugs that proteus mirabilis has developed resistance to such as ampicillin. Proteus. Su CH, Wang JT, Hsiung CA, Chien LJ, Chi CL, Yu HT, Chang FY, Chang SC: Increase of carbapenem-resistant Acinetobacter baumannii infection in acute care hospitals in Taiwan: association with hospital antimicrobial usage. Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan S. Road, Taipei, 10002, Taiwan, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, No. However, national data on the susceptibilities of P. mirabilis from different sources are limited. and cross-sectional study. 10.3201/eid1710.110655. The mean age of the patients was 62.8 ± 24.7 years, with 9.2% being pediatric patients (≤18 years), 29.6% being adult (19–64 years), and 61.3% being elderly (≥65 years). Cefepime breakpoints were also revised in 2014. In addition, compared to recent reports from the United States, Canada, and United Kingdom, our results showed that P. mirabilis in Taiwan have lower rates of susceptibility to cefotaxime (85.7% vs. > 97% in US, Canada, and UK) and gentamicin (57.7% vs. > 90%) [12, 15–17]. Clinical and Laboratory Standards Institute: Methods for Dilution Antimicrobial Susceptibility tests for Bacteria That Grow Aerobically; Approved Standard-Ninth Edition. Antimicrob Agents Chemother. 2014, Wayne, PA: CLSI, Document M100-S24. Therefore, the new CLSI carbapenem breakpoints can have significant effect on the rate of imipenem susceptibility in P. mirabilis. This information can be helpful in therapy selection for uncomplicated UTIs. Clinical and Laboratory Standards Institute (CLSI). Susceptibility interpretation analysis was made using the WHONET software [28]. P. mirabilis isolates were collected as part of the TSAR program. Castanheira M, Farrell SE, Krause KM, Jones RN, Sader HS: Contemporary diversity of β-lactamases among Enterobacteriaceae in the nine U.S. Census regions and ceftazidime-avibactam activity tested against isolates producing the most prevalent β-lactamase groups. 2011, 24: 281-295. Breakpoints for different carbapenems were updated in June 2010 and in 2012. 1997, 61: 65-89. Duplicate isolates were excluded from analysis. SYNOPSISAstudy has been made of the antibiotic sensitivitypatternof 96 strains of Proteus isolated from clinical material andafurther 29 strains kindly supplied by Dr. Patricia Carpenter. P. mirabilis was susceptible to cephalosporins and β-lactam/β-lactamase inhibitors. 35 Keyan Road, Zhunan, 35053, Taiwan, Jann-Tay Wang, Pei-Chen Chen, Yih-Ru Shiau, Hui-Ying Wang, Jui-Fen Lai, I-Wen Huang, Mei-Chen Tan & Tsai-Ling Yang Lauderdale, College of Medicine, National Taiwan University, 1 Jen-Ai Road Section 1, Taipei, 10051, Taiwan, You can also search for this author in A value of 1.0 μg/mL ciprofloxacin is MBE50 for the strains of both tested species. Perez-Perez FJ, Hanson ND: Detection of plasmid-mediated AmpC β-lactamase genes in clinical isolates by using multiplex PCR. The prevalence of AmpC β-lactamase-producing P. mirabilis also increased significantly. Proteus mi. Antimicrobial susceptibilities of Proteus mirabilis: a longitudinal nationwide study from the Taiwan surveillance of antimicrobial resistance (TSAR) program. If a reaction occurs, discontinue the implicated drug unless the condition is life threatening and amenable only to therapy with that antibiotic. Isolates from outpatients had significantly higher rates of susceptibility to ampicillin, amoxicillin/clavulanate, cefazolin (by CLSI 2009 criteria), cefuroxime, cefotaxime, ciprofloxacin, gentamicin, and piperacillin. For isolates with colony morphology or any biochemical reactions not typical of P. mirabilis, either Vitek I (prior to 2008) or Vitek II (2008 to 2012) GN cards were used (bioMérieux, Marcy l’Etoile, France). Whether this phenomenon was due to clonal spread or horizontal gene transfer requires further study. Therefore, applying the revised CLSI criteria would result in significantly fewer carbapenem-susceptible P. mirabilis being reported. Therefore, the results presented here are a representation of the total number of P. mirabilis in Taiwan. 10.1128/AAC.49.7.2598-2605.2005. Antimicrobial susceptibility of Proteus mirabilis against different antibiotic was evaluated by Kirby-Baur Method. For these reasons, this research was performed to identify the antibiotics to which S. marcescens and P. mirabilis have shown resistance over the past 10 years. However, the prevalence of AmpC β-lactamases gene carriage increased significantly (from 0 to 7.0%, P <0.001; Table 1). The present study analyzed the TSAR data from period III (2002) to VIII (2012) to address the above issues. Cite this article. rabilis (P. mirabilis) is a species of Gram-negative and facultative anaerobic bacteria that shows swarming motility and urease activity. Bacterial persistence is a phenomenon in which a subpopulation of cells survives antibiotic treatment. The proteus was isoalted from that fluid. antibiotic resistance in S. marcescens and P. mirabilis. SHV, bla Patient age and location were factors independently associated with the presence of ESBL and/or AmpC β-lactamase-producers. Article  Privacy The bacterial isolates were recovered from clinical samples taken as part of standard care. Studies from Taiwan on other species of Enterobacteriaceae have found CTX-M-type ESBL and CMY-type and DHA-type AmpC β-lactamases to be prevalent, including Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp. In Taiwan, P. mirabilis remains an important pathogen causing UTI among patients with urolithiasis and urinary catheters in both community and healthcare settings [22]. Factors associated with carriage of ESBL included age and patient location using univariate analysis (Table 4). CLSI lowered the susceptibility breakpoints of Enterobacteriaceae, including P. mirabilis, for 3rd-generation cephalosporins in 2010 to facilitate the identification of isolates having ESBLs and/or AmpC β-lactamases [33]. Hawser SP, Badal RE, Bouchillon SK, Hoban DJ, Hsueh PR: Comparison of CLSI 2009, CLSI 2010 and EUCAST cephalosporin clinical breakpoints in recent clinical isolates of Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca from the SMART global surveillance study. Minimum inhibitory concentrations (MIC) were determined by reference broth microdilution method. ), 2.02–7.33; P <0.001] and patient location (ICU vs. outpatients; OR, 1.99; 95% C.I., 1.04–3.84; P = 0.039) remained independent factors associated ESBL genes carriage. Natural antibiotic susceptibility of Proteus spp., with special reference to P. mirabilis and P. penneri strains. 10.1016/S0966-842X(00)88945-3. 10.1016/j.diagmicrobio.2013.11.025. 2013, 32: 253-259. 10.1017/S0950268813000988. Article  These bacteria are gram negative rod measuring (1-3) µm in length and (0.4-0.8) µm in diameter, motile by. Minimum biofilm eradication values of ciprofloxacin obtained in the study are close to the values of the minimal inhibition concentration (MIC). Knowledge of the microbial flora of an environment and the sensitivity pattern are important tools in the management of wound infections especially those caused by Proteus species, and are also useful in formulating rational antibiotic policy. Antimicrob Agents Chemother. Hawser SP, Badal RE, Bouchillon SK, Hoban DJ, Hackel MA, Biedenbach DJ, Goff DA: Susceptibility of gram-negative aerobic bacilli from intra-abdominal pathogens to antimicrobial agents collected in the United States during 2011. These drugs are prescribed to relieve bladder spasms that cause the sense of urgent and painful urination during some Proteus UTIs. A study from Canada also showed similar MIC distribution in P. mirabilis, with 4.2% and 63.6% of isolates in the susceptible and intermediate category, respectively [17]. By specimen types, isolates recovered from sputum had significantly lower susceptibility to cefazolin (by CLSI 2009 criteria), piperacillin, and trimethoprim/sulfamethoxazole compared to other specimen types. Surgery can also be used if … 2011, 70: 423-424. Nordmann P, Naas T, Poirel L: Global spread of carbapenemase-producing Enterobacteriaceae. All isolates were subcultured twice on sheep blood agar plates from -70°C prior to AST. 2013, 56: 1301-1309. Centers for Diseases Control and Prevention: The CDC guidance for control of CRE-2012 CRE toolkit. J Infect. Cross-sensitivity between penicillins and cephalosporins has occurred. M100-S19. Nineteenth Informational Supplement. Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing. Compared to non-ESBL phenotype and ESBL- and AmpC- negative isolates, ESBL and AmpC β-lactamase-producing isolates had significantly lower rates of susceptibility to amikacin (28.4% - 57.1% vs. 97.8%), cefotaxime (0 vs. 99.7%), and ciprofloxacin (6.8% - 42.9% vs. 75.9%) (Table 3). SCC participated in the design and data interpretation of the study. 2017 Jun;17(2):356-365. doi: 10.4314/ahs.v17i2.9. Therefore, carbapenemases do not currently appear to be prevalent in P. mirabilis in Taiwan. are commensal Enterobacterales of the human digestive tract. Proteus mirabilis UTI. The lower and decreased susceptibility to ciprofloxacin over the study periods might be due to increased consumption of fluoroquinolones in Taiwan in recent years [30]. CAS  Bouchillon SK, Badal RE, Hoban DJ, Hawser SP: Antimicrobial susceptibility of inpatient urinary tract isolates of gram-negative bacilli in the United States: results from the Study for Monitoring Antimicrobial Resistance Trends (SMART) program: 2009–2011. The research included 50 P. mirabilis strains isolated from wounds and the urinary tracts from patients of the University Hospital No. Manage cookies/Do not sell my data we use in the preference centre. Publicado el diciembre 17, 2020 por — Dejar un comentario what antibiotics kill proteus mirabilis? Microbiol Mol Biol Rev. Using the current CLSI breakpoints, none of 142 isolates with either ESBL or AmpC gene was susceptible to cefotaxime [sensitivity, 100%; specificity, 97.5%; positive predictive value (PPV), 86.1%; negative predictive value (NPV), 100%].
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