Molecular characterization and antibiotic susceptibility of Proteus mirabilis isolated from different clinical specimens in Zakho city, Kurdistan Region, Iraq.
Keywords:P. mirabilis, Virulence genes, Antibiotics resistant, Zakho city
Proteus mirabilis is one of the important causative agents of bacterial infections in humans. This study involved the prevalence of the virulence genes among P. mirabilis from urine, ear, sputum, burn, wound, and vagina specimens in Zakho city during the period of July 2021 until January 2022 and their susceptibility to different commonly used antimicrobial agents. Isolates were identified by traditional phenotypic and biochemical tests. Out of 400 cultures, 95 (23.75%) were P. mirabilis. The antibiotic susceptibility toward different antibiotics varied among the isolates. The results showed that ceftriaxone was the most potent antibiotic with a susceptibility rate of 90.28 %. The isolates were resistant to many screened antibiotics, with the highest rate of 88.42% to imipenem. Whereas, the resistant proportion was slightly lower toward other antibiotics at rates varied from 74.68 % and 77.89% for Ampicillin and Amoxicillin/clavulanic acid, respectively. Fifty-two P. mirabilis isolates were selected for PCR analysis, according to their multiple antimicrobial resistance to the used antibiotics. The selected samples were amplified for P. mirabilis identification by producing a single band of the ureR gene. The prevalence of the virulence genes (flaA, rsbA, zapA, and mrpA) among these isolates were 96.15%, 88.46%, 80.77%, and 69.23%, respectively. This study demonstrates that multidrug resistance P. mirabilis harbors multiple virulence genes.
ABDULLAH, M. A., ABUO-RAHMA, G. E. D. A., ABDELHAFEZ, E. S. M., HASSAN, H. A., AND ABD EL-BAKY, R. M. 2017. Design, synthesis, molecular docking, anti-Proteus mirabilis and urease inhibition of new fluoroquinolone carboxylic acid derivatives, Bioorganic Chemistry, 70, 1-11.
AL-BASSAM, W. W., AND AL-KAZAZ, A. K. 2013. The isolation and characterization of Proteus mirabilis from different clinical samples, Journal of Biotechnology Research Center, 7, 24-30.
Agha, Z. H. M., & Al-Delaimi, M. S. 2021. Prevalence of common bacterial etiology and antimicrobial susceptibility pattern in patients with otitis media in Duhok Province–Iraq, Zanco Journal of Pure and Applied Sciences, 33, 11-25.
AL-HAMDANI, H., AND AL-HASHIMY, A. 2020. Molecular detection of ureC, hpmA, rsbA and mrpA genes of Proteus Mirabilis urinary tract infection in patient with rheumatoid arthritis. The Iraqi Journal of Agricultural Science, 51, 245-251.
ALI, H. H., AND YOUSIF, M. G. 2015. Detection of some virulence factors genes of Proteus mirablis that isolated from urinary tract infection, IJAR, 3, 156-163.
AL-OQAILI, N. A. D., AL-SHEBLI, M. K., AND ALMOUSAWI, A. N. 2017.
Antimicrobial susceptibility and molecular characterization for
some virulence factors of Proteus mirabilis isolated from patients in Al-Qadisiyah Province/Iraq, AL-Qadisiyah Journal of Veterinary Medicine Sciences, 16, 1-7.
ALABI, O. S., MENDONÇA, N., ADELEKE, O. E., AND DA SILVA, G. J. 2017. Molecular screening of antibiotic-resistant determinants among multidrug resistant clinical isolates of Proteus mirabilis from SouthWest Nigeria, African health sciences, 17, 356-365.
AL-JEBOURI, M. M., AND AL-ALWANI, H. R. 2015. Antibiotic Resistance patterns of bacterial types Isolated from urine of Iraqi patients with renal failure, World Journal of Pharmaceutical Research, 4, 217-233.
AGHAPOUR, Z., GHOLIZADEH, P., GANBAROV, K., BIALVAEI, A. Z., MAHMOOD, S. S., TANOMAND, A., ... AND KAFIL, H. S. 2019. Molecular mechanisms related to colistin resistance in Enterobacteriaceae, Infection and drug resistance, 12, 965.
ABD AL-MAYAHI, F. S. 2017. Phenotypic and Molecular detection of Virulence factors in Proteus mirabilis isolated from different clinical sources. Bas J Vet Res, 16, 369-88.
Ahmed, D. A. 2015. Prevalence of Proteus spp. in some hospitals in Baghdad City, Iraqi Journal of Science, 56, 665-672.
BAMERI, Z., KARAM, M. R. A., HABIBI, M., EHSANI, P., AND BOUZARI, S. 2018. Determination immunogenic property of truncated MrpH. FliC as a vaccine candidate against urinary tract infections caused by Proteus mirabilis, Microbial pathogenesis, 114, 99-106.
BADI, S. A., NOROUZY, J., AND SEPAHI, A. A. 2014. Detection rsbA gene's band & effect of miristic acid in virulence of Proteus mirabilis isolated from urinary tract infrction, Iranian Journal of Public Health, 43, 210.
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Test; Approved Standards-Twelfth Edition. CLSI document M02-A12. Wayne. PA: Clinical and Laboratory Standards Institute; 2015.
EVANS, D. R., GRIFFITH, M. P., SUNDERMANN, A. J., SHUTT, K. A., SAUL, M. I., MUSTAPHA, M. M., ... AND VAN TYNE, D. 2020. Systematic detection of horizontal gene transfer across genera among multidrug-resistant bacteria in a single hospital, Elife, 9, e53886.
GORIČKI, Š., STANKOVIĆ, D., SNOJ, A., KUNTNER, M., JEFFERY, W. R., TRONTELJ, P., ... AND ALJANČIČ, G. 2017. Environmental DNA in subterranean biology: range extension and taxonomic implications for Proteus, Scientific Reports, 7, 1-11.
GIRLICH, D., BONNIN, R. A., DORTET, L., AND NAAS, T. 2020. Genetics of acquired antibiotic resistance genes in Proteus spp. Frontiers in Microbiology, 11, 256.
GHAIMA, K. K., HAMID, H. H., AND HASAN, S. F. 2017. Biofilm formation, antibiotic resistance and detection of mannose-resistant Proteus-like (MR/P) fimbriae genes in Proteus mirabilis isolated from UTI, International Journal of ChemTech Research, 10, 964-971.
GOMAA, S., SERRY, F., ABDELLATIF, H., & ABBAS, H. 2019. Elimination of multidrug-resistant Proteus mirabilis biofilms using bacteriophages, Archives of virology, 164, 2265-2275.
HUSSEIN, E. I., AL-BATAYNEH, K., MASADEH, M. M., DAHADHAH, F. W., AL ZOUBI, M. S., ALJABALI, A. A., AND ALZOUBI, K. H. 2020. Assessment of pathogenic potential, virulent genes profile, and antibiotic susceptibility of Proteus mirabilis from urinary tract infection, International Journal of Microbiology, 2020, 5.
JARJES, S. F. 2019. Isolation, Identification, and Antibiotics Susceptibility Determination of Proteus Species Obtained from Various Clinical Specimens in Erbil City, Polytechnic Journal, 9, 86-92.
JAWAD, N., AND ALRAMAHY, S. K. 2017. Diagnosis of Proteus mirabilis using PCR technique and determining their sensitivity to some antibiotics, Al-Qadisiyah Journal of Pure Science, 22, 692-703.
JAMEEL, A. Y., AND ARTOSHI, D. M. 2019. Prevalence of Urinary Tract Infections and Their Antimicrobial Sensitivity Among Diabetic and Non-Diabetic Patients in Zakho, Science Journal of University of Zakho, 7, 125-131.
KAMIL, T. D., AND JARJES, S. F. 2021. Molecular Characterization of Proteus spp. from Patients Admitted to Hospitals in Erbil City, Polytechnic Journal, 11(2), 95-99.
KORYTNY, A., RIESENBERG, K., SAIDEL-ODES, L., SCHLAEFFER, F., AND BORER, A. 2016. Bloodstream infections caused by multi-drug resistant Proteus mirabilis: Epidemiology, risk factors and impact of multi-drug resistance, Infectious diseases, 48, 428-431.
LIU, Y., CAO, Y., WANG, T., DONG, Q., LI, J., AND NIU, C. 2019. Detection of 12 common food-borne bacterial pathogens by TaqMan real-time PCR using a single set of reaction conditions, Frontiers in Microbiology, 10, 222.
MAJEED, H. T., AND ALJANABY, A. A. J. 2019. Antibiotic susceptibility patterns and prevalence of some extended spectrum beta-lactamases genes in gram-negative bacteria isolated from patients infected with urinary tract infections in Al-Najaf City, Iraq, Avicenna journal of medical biotechnology, 11, 192.
MILO, S., HEYLEN, R. A., GLANCY, J., WILLIAMS, G. T., PATENALL, B. L., HATHAWAY, H. J., ... AND JENKINS, A. T. A. 2021. A small-molecular inhibitor against Proteus mirabilis urease to treat catheter-associated urinary tract infections, Scientific reports, 11, 1-15.
MAHMOOD AGHA, Z. AND S. AL-DELAIMI, M. 2021. Prevalence of common bacterial etiology and antimicrobial susceptibility pattern in patients with otitis media in Duhok Province –Iraq, Zanco Journal of Pure and Applied Sciences, 33, 11-25.
NASERI, H., SHARIFI, A., GHAEDI, M., DASHTIAN, K., KHORAMROOZ, S. S., MANZOURI, L., ... AND ASKARINIA, M. 2018. Sonochemical incorporated of cytosine in Cu-H2bpdc as an antibacterial agent against standard and clinical strains of Proteus mirabilis with rsbA gene, Ultrasonics Sonochemistry, 44, 223-230.
NORSWORTHY, A. N., AND PEARSON, M. M. 2017. From catheter to kidney stone: the uropathogenic lifestyle of Proteus mirabilis, Trends in microbiology, 25, 304-315.
NAQID, I. A., BALATAY, A. A., HUSSEIN, N. R., AHMED, H. A., SAEED, K. A., & ABDI, S. A. 2020. Bacterial strains and antimicrobial susceptibility patterns in male urinary tract infections in Duhok province, Iraq, Middle East Journal of Rehabilitation and Health Studies, 7, e103529.
PERWEEN N, PRAKASH SK, BHARARA T. 2016. Prevalence of Multidrug-Resistant and Extensively Drug-Resistant Proteus, Providencia and Morganella Species in Burn Wound Infection, International Journal of Scientific Study, 3, 154-156.
RAMOS, A. C., CAYÔ, R., CARVALHAES, C. G., JOVÉ, T., DA SILVA, G. P., SANCHO, F. M. P., ... AND GALES, A. C. 2018. Dissemination of multidrug-resistant Proteus mirabilis clones carrying a novel integron-borne bla IMP-1 in a tertiary hospital, antimicrobial agents and chemotherapy, 62, e01321-17.
RAM, P., RAO, V., RAO, S., SUBRAMANYAM, K. V., & SRINIVAS, K. 2019. Prevalence and virulence gene profiles of Proteus mirabilis isolated from animal, human and water samples in Krishna District, Andhra Pradesh, India, Pharma Innov. J, 8, 19-23.
RAHEEM, R. S. A., HUSSEIN, M. A., & AL-DIN, N. I. 2019. Causative organism of urinary tract infection and drug resistance in children at child’s Central Teaching Hospital in Baghdad City, JPMA, 69.
STANKOWSKA, D., KWINKOWSKI, M., AND KACA, W. 2008. Quantification of Proteus mirabilis virulence factors and modulation by acylated homoserine lactones, J Microbiol Immunol Infect, 41, 243-253.
SHOAIB, M., MUZAMMIL, I., HAMMAD, M., BHUTTA, Z. A., & YASEEN, I. 2020. A mini-review on commonly used biochemical tests for identification of bacteria, A Mini-Review on Commonly used Biochemical Tests for Identification of Bacteria, International Journal of Research Publications, 54, 8-8.
TABATABAEI, A., AHMADI, K., SHABESTARI, A. N., KHOSRAVI, N., AND BADAMCHI, A. 2021. Virulence genes and antimicrobial resistance pattern in Proteus mirabilis strains isolated from patients attended with urinary infections to Tertiary Hospitals, in Iran, African Health Sciences, 21, 1677-84.
THABIT, A. G., EL-SABOUR, A., NAFIE, A. M. A., EL-MOKHTAR, M. A., AND BIOMY, Y. E. 2020. Detection of Proteus species in diabetic wounds and their antibiotic resistance profile analysis, Bulletin of Pharmaceutical Sciences, 43, 1-10.
TOLULOPE, A., EWAOCHE, I. S., AND IBEMOLOGI, A. 2021. ureC and zapA virulence genes amplification in clinical specimen of Proteus mirabilis in Bayelsa state, Nigeria, Journal of Microbiology & Experimentation, 9, 15-20.
WANG, Z., ZUO, J., GONG, J., HU, J., JIANG, W., MI, R., ... AND HAN, X. 2019. Development of a multiplex PCR assay for the simultaneous and rapid detection of six pathogenic bacteria in poultry, Amb Express, 9, 1-11.
YILMAZ, M., OZIC, C., & GOK, İ. 2012. Principles of nucleic acid separation by agarose gel electrophoresis, Gel Electrophoresis–Principles and Basics, 4, 33.
ZAFAR, U., TAJ, M. K., NAWAZ, I., ZAFAR, A., AND TAJ, I. 2019. Characterization of Proteus mirabilis Isolated from Patient Wounds at Bolan Medical Complex Hospital, Quetta, Jundishapur Journal of Microbiology, 12, 1-6.
ZHANG, W., NIU, Z., YIN, K., LIU, P., AND CHEN, L. 2013. Quick identification and quantification of Proteus mirabilis by polymerase chain reaction (PCR) assays, Annals of microbiology, 63(2), 683-689.
ZUNINO, P., GEYMONAT, L., ALLEN, A. G., PRESTON, A., SOSA, V., AND MASKELL, D. J. 2001. New aspects of the role of MR/P fimbriae in Proteus mirabilis urinary tract infection, FEMS Immunology & Medical Microbiology, 31, 113-120.
ZANICHELLI, V., HUTTNER, A., HARBARTH, S., KRONENBERG, A. O., AND HUTTNER, B. 2019. Antimicrobial resistance trends in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis urinary isolates from Switzerland: retrospective analysis of data from a national surveillance network over an 8-year period (2009-2016), Swiss medical weekly, 149, w20110.
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