GENETIC DETERMINATION OF CARBAPENEMASES AMONG CARBAPENEM - RESISTANT PROTEUS MIRABILIS ISOLATED FROM CLINICAL SAMPLES, IRAQ

Background and aims: Proteus mirabilis is an enterobacterial species that naturally colonizes the gastrointestinal lumen. It is an opportunistic pathogen responsible for serious infections of the human urinary tract, respiratory tract, wounds, otitis media, and blood. It poses a potential threat to patients via the production of β-lactamases, which decrease the efficacy of antimicrobial treatment and impair the management of its pathogenicity. This study was established to determine the prevalence of carbapenemases of P. mirabilis isolated from various clinical specimens. Materials and methods: In this study clinical samples were collected from (urine, wound and ear swab), and among these isolates, Proteus mirabilis was identified by phenotype and genotype Results: The study includes the collection of 250 samples from different clinical sources, including urine (40.4%), wounds (43.6%) and ear swabs (16%) from patients attending Al- Kut Hospitals and private clinics, The prevalence of P. mirabilis was 10.4% among all collected samples, female infection rate was 30.7%, male infection rate was 69.2%. The age group ≥50 years was commonly infected with P. mirabilis. All Proteus mirabilis isolates were examined for their resistance against 17 antibiotics belonging to different classes, the highest rates of resistance were against class Tetracyclines antibiotic (doxycyclin) was 100%, and maximal sensitivity has been to norfloxacin, meropenem,doprapemen was 92,3%. In a phenotypic analysis production carbapenemase, it was discovered that 11% of clinical isolates was Proteus mirabilis. Genotypically isolates were carbapemase producers, 26.9% of isolates were carbapemase producers KPC-type carbapemase, while other gens (blaIMP, blaVIM, blaOXA, blaSIM and NDM-1) were absent among all isolates. Conclusion: There is an urgent need to monitor hospitalized patients and improve healthcare in order to reduce the incidence of infection and outbreaks of infection with antibiotic-resistant Proteus.