Abstract
Background: Emerging antibiotic resistance (ABR) in Proteus spp., especially to third-generation cephalosporins (3GCc), carbapenems, and fluoroquinolones, challenges the treatment outcome and infection prevention. Limited studies pose a knowledge gap between them and ABR.
Methods: We investigated the in vitro efficacy of therapeutic options and prevalence of β-lactamase and plasmid-mediated quinolone resistance (PMQR) traits in 3GC- and/or fluoroquinolone- nonsusceptible Proteus (P.) spp. (n=27) in Kolkata, India, during 2021–2022. P. mirabilis was commonly isolated (>80%) from superficial and urine samples. The majority of the isolates (48-78%) remained susceptible to piperacillin-tazobactam, meropenem, amikacin, cefoperazonesulbactam, and cefepime.
Results: All isolates showed >0.2 multiple-antibiotic resistance index, with >65% being multidrug and >30% being extensively drug-resistant. blaTEM (n=9), blaNDM (n=9), and qnrA (n=6) were commonly noted with the co-production of β-lactamases and PMQR in ten (37%) isolates. More than 50% of the isolates were devoid of the tested acquired genes.
Conclusion: The study concludes that superbugs dominate, with limited occurrence of plasmidborne markers in this geographic location.
[http://dx.doi.org/10.1128/CMR.13.4.534] [PMID: 11023955]
[http://dx.doi.org/10.1128/microbiolspec.UTI-0017-2013] [PMID: 26542036]
[http://dx.doi.org/10.1186/1471-2334-14-486] [PMID: 25192738]
[http://dx.doi.org/10.1093/infdis/146.6.719] [PMID: 6815281]
[http://dx.doi.org/10.51429/EJMM30115]
[http://dx.doi.org/10.1179/joc.2003.15.1.12] [PMID: 12678409]
[http://dx.doi.org/10.3389/fmicb.2020.00256] [PMID: 32153540]
[http://dx.doi.org/10.1186/s12866-022-02662-3] [PMID: 36221063]
[http://dx.doi.org/10.1093/jac/36.2.335] [PMID: 8522463]
[http://dx.doi.org/10.1128/AAC.04634-14] [PMID: 26169415]
[http://dx.doi.org/10.1099/jmm.0.064428-0] [PMID: 24000223]
[http://dx.doi.org/10.1099/jmm.0.049726-0] [PMID: 22935848]
[http://dx.doi.org/10.7860/JCDR/2022/51928.15901]
[http://dx.doi.org/10.2174/1871526517666170425125217] [PMID: 28443500]
[http://dx.doi.org/10.1128/JCM.41.9.4264-4269.2003] [PMID: 12958255]
[http://dx.doi.org/10.1128/AAC.44.7.1930-1935.2000] [PMID: 10858357]
[http://dx.doi.org/10.1093/jac/dki135] [PMID: 15857942]
[http://dx.doi.org/10.1186/s12941-015-0108-y] [PMID: 26526183]
[http://dx.doi.org/10.1128/AAC.48.1.1-14.2004] [PMID: 14693512]
[http://dx.doi.org/10.1080/20477724.2023.2201982] [PMID: 37069793]
[http://dx.doi.org/10.1007/s10123-023-00451-0] [PMID: 37985632]
[http://dx.doi.org/10.1016/j.jiac.2016.12.013] [PMID: 28161293]
[http://dx.doi.org/10.1590/0037-8682-0152-2014] [PMID: 25860472]
[http://dx.doi.org/10.1128/genomeA.00607-16] [PMID: 27340072]
[http://dx.doi.org/10.1128/AAC.00260-09] [PMID: 19620332]
[http://dx.doi.org/10.1128/AAC.01321-17] [PMID: 29158274]
[PMID: 34999676]
[http://dx.doi.org/10.1089/mdr.2012.0146] [PMID: 23557071]
[http://dx.doi.org/10.1016/j.jgar.2014.05.005] [PMID: 27873695]
[http://dx.doi.org/10.1016/j.ijantimicag.2010.08.019] [PMID: 21074376]
[http://dx.doi.org/10.1111/j.1469-0691.2011.03728.x] [PMID: 22192340]
[http://dx.doi.org/10.1371/journal.pone.0087801] [PMID: 24504382]
[http://dx.doi.org/10.1111/j.1600-0463.2012.02923.x] [PMID: 23030307]