Investigation of blaTEM among Multidrug-Resistant Proteus mirabilis Isolated from Urinary Tracts Infection

Abstract Background: Any component of the urinary system can get infected, which is what a urinary tract infection (UTI) is. Most infections affect the lower urinary tract (bladder and the urethra). UTIs are frequent infections that develop when germs, frequently from the skin or rectum, pass through the urethra and infect the urinary system. Objective: The current study aims to investigate blaTEM gene among multidrug-resistant (MDR) and nonmultidrug-resistant (non-MDR) Proteus mirabilis isolated from patients with UTI. Materials and Methods: Collected 450 (325 male and 125 female) with UTIs. These patients ranged in age from 17 to 70 years old from three Iraqi hospitals (Babylon Hospital for Maternal and Pediatrics, Al-Hilla Surgical Teaching Hospital, Merjan Hospital, and Shomali General Hospital) from the period from September to December. Samples were grown on MacConkey agar and blood agar to separate Gram-negative, nonlactose-fermenting colonies exhibiting swarming behavior. Biochemicals were also used to confirm P. mirabilis . Molecular detection of P. mirabilis achieved by amplification of atpD gene. Antibiotic susceptibility tests by disc diffusion method were performed for 15 antibiotics from 6 different classes to assign the isolated to MDR or non-MDR. Finally, the amplification of blaTEM gene was achieved using polymerase chain reaction (PCR) technique and specific primer pairs. Results: The result of culture, biochemical, Gram stain, and genetic ( atpD gene) present the percentage of samples positive for P. mirabilis was 70 samples (15.5%). The result of antibiotic susceptibility showed that all isolated resistant to Nitrofurantoin (92.8%), Trimethoprim–Sulfamethoxazole (85.7%), Cefotaxime (78.5%), Cefuroxime (68.5%), Ceftazidime (58.5%), Gentamycin (38.5%), Ciprofloxacin (37.1%), and Levofloxacin (28.5%). While the lower resistance against Amikacin (10%), Imipenem (4.2%), Aztreonam (2.8%), and Meropenem (1.4%). The result showed 64 (91.4%) of 70 were positive for the blaTEM gene; among them, 60 (93.75%) were MDR and 4 (6.6%) were non-MDR. Conclusions: Most P. mirabilis isolates were found to MDR with different percentages of resistance to different antibiotics, and blaTEM -carrying isolates showed high resistance to Nitrofurantoin, Trimethoprim–Sulfamethoxaz.