Emergence of β-lactamase-producing Proteus mirabilis in clinical settings: A genotypic investigation of resistance mechanisms and carbapenemase genes blaNDM-1 and blaKPC-2

<i>Proteus mirabilis</i>, an opportunistic pathogen frequently implicated in urinary and wound infections, has shown increasing multidrug resistance, posing significant therapeutic challenges. The study aims to investigate the prevalence and distribution of β-lactam resistance in <i>P. mirabilis</i> clinical isolates through the genotypic detection of the <i>bla</i> _KPC-2 and <i>bla</i> _NDM-1 genes. This study analyzed 100 clinical isolates of <i>P. mirabilis</i> obtained from various clinical specimens over a period of 10 months. Isolates were identified through standard microbiological techniques, including Gram staining, culture characteristics, and biochemical profiling. The majority of isolates (46 %) were recovered from patients aged 61-75 years, with a male predominance (65 %). Pus samples accounted for the highest number of isolates (59 %), predominantly associated with diabetic foot ulcers, cellulitis, and gangrene. Antimicrobial susceptibility testing using Vitek (bioMérieux) showed that 33.31 % of isolates were resistant to commonly used antibiotics, with the highest resistance noted against ciprofloxacin (58 %), ceftazidime (50 %), and cotrimoxazole (49 %). However, piperacillin-tazobactam (96 %), Fosfomycin (94 %), and ertapenem (87 %) remained largely effective. Multidrug resistance was observed in 83 % of isolates, with 18 % showing resistance to six antibiotic classes. Molecular characterization showed that 19 % of isolates harbored the <i>bla</i> _NDM-1 gene, 8 % carried <i>bla</i> _KPC-2, and 4 % co-harbored both, indicating carbapenemase production. These findings underscore the urgent need for continuous surveillance, strict infection control measures, and prudent antibiotic use to curb the emergence and spread of resistant <i>P. mirabilis</i> strains in clinical settings.