Isolation and Antimicrobial Resistance of Proteus mirabilis in Patients with Commuinity – acquired Urinary Tract Infections

Abstract

This study was carried out in Khartoum state during the period from November 2008 to March 2009, to investigate antimicrobial resistance of Proteus mirabilis isolated from patients suffering from community - acquired urinary tract infections. Two hundred and nineteen urine specimens were collected from patients attending Khartoum Teaching Hospital, Fudail Center, Gaffer Iben Auff specialized Hospital for Children and Khartoum North Teaching Hospital. The specimens were cultured on blood and MaCconkey's agars for primary isolation of the pathogen. Identification of the isolates was done by colonial morphology, gram stain and biochemical tests using API 20E. Modified Kirby-Bauer disc diffusion method was adopted to determine the resistance rate of P. mirabilis to nitrofuratoin, amoxicillin, nalidixic acid, co- trimoxazole, amoxyclav, ticarcillin, ciprofloxacin and ceftriaxone. Minimum inhibitory concentrations (MICs) of ceftriaxone, amoxyclav, co-trimoxazole, ciprofloxacin and chloramphenicol were determined by E. test. Out of the two hundred and ninteen urine specimens examined, only 10 (4.6 %) P. mirabilis were recovered. The result revealed that the antimicrobial resistance of P. mirabilis was as follows: amoxicillin and nitrofuratoin (100% each), co-trimoxazole (40 %), nalidixic acid, Ciprofloxacin and Ceftriaxone (20.% each), and no resistant was observed to amikacin, ticarcillin and amoxyclav. The result indicated that the MIC, MIC50 and MIC90 of amoxyclav were (4 μg/ml, each), co-trimoxazole (0.5 - 4 μg/ml, 0.5μg/ml and 4 μg/ml), ceftriaxone (0.008- 0.08μg/ml, 0.008μg/ml and 0.08 μg/ml) and ciprofloxacin (0.001- 0.01μg/ml, 0.001μg/ml and 0.0 μg/ml). The study concluded that the responsibility of P. mirabilis to UTIs slightly higher than previously recorded. The antimicrobial resistance of P. mirabilis to traditionally used antibiotics was also high.