Concurrent extended spectrum beta-lactamase production and multidrug resistance among Proteus species isolated from clinical samples of patients attending selected hospitals in Northeastern Nigeria

Abstract

Proteus species are rod-shaped, Gram-negative bacteria that cause opportunistic infections in the urinary tract and occasionally in the gastrointestinal tract. They are implicated in infections like cystitis and pyelonephritis, particularly in immunocompromised individuals, and are frequently present in cases of asymptomatic bacteriuria. Herein, we aimed to investigate the co-occurrence of extended-spectrum beta-lactamase (ESBL) enzyme production and multidrug resistance (MDR) among Proteus spp. Isolated from patients attending selected hospitals in Northeastern Nigeria. A total of 1,500 clinical samples from consenting patients across six states in the Northeastern region of Nigeria were collected. The samples were cultured on Blood agar, and growth resembling that of Proteus species were again subcultured onto MacConkey agar to obtain discrete colonies, further confirmed using biochemical tests. Antibiotics susceptibility test was carried out for all isolates using the Kirby-Bauer disc diffusion method, coupled with a screening of the production of extended-spectrum beta-lactamase using the Combined Disc Diffusion Method. Of the 1500 samples collected, 144 yielded positive growth for Proteus spp., resulting in a prevalence rate of 9.60%. Among these Proteus isolates, three species were identified, with Proteus mirabilis (90.97%) being the most abundant, followed by Proteus vulgaris (8.33%) and Proteus penneri (0.70%). The Proteus isolates displayed significant resistance to β-lactam antibiotics, with a Mean ± SD of 96.64 ± 22.73. A substantial portion of the Proteus spp. Isolated exhibited multidrug resistance (87.89%), with Proteus mirabilis (82.27%) being the most prevalent MDR species. Moreover, about 71.0% of the Proteus spp were ESBL producers, with Proteus mirabilis (64.54%) being the most predominant. Furthermore, 67.38% of all isolates exhibited MDR and ESBL production, and Proteus mirabilis (62.41%) was the most significant among the three Proteus species. These findings highlight the occurrence of multidrug resistance and ESBL production among Proteus spp. in Northeastern Nigeria, with Proteus mirabilis particularly noteworthy. This information is crucial for guiding clinical decision making, especially in managing infections caused by multidrugresistant and ESBL-producing Proteus strains.