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. 2018;67(4):471-478.
doi: 10.21307/pjm-2018-055.

Primary and Secondary Bacteremia Caused by Proteus spp.: Epidemiology, Strains Susceptibility and Biofilm Formation

Joanna Kwiecińska-Piróg  1 , Krzysztof Skowron  1 , Eugenia Gospodarek-Komkowska  1
Affiliations

Primary and Secondary Bacteremia Caused by Proteus spp.: Epidemiology, Strains Susceptibility and Biofilm Formation

Joanna Kwiecińska-Piróg et al. Pol J Microbiol. 2018.

Abstract

Proteus spp. is an etiological factor of urinary tract and bloodstream infections. The aim of this study was the retrospective analysis of susceptibility of Proteus spp. strains isolated from bloodstream infections (BSIs) as well as similarity evaluation of the strains isolated from different clinical samples. Proteus spp. strains were isolated in 2009-2017 from hospital patients. Identification was based on the colony's morphology and biochemical or MALDI-TOF MS analyzes. The antibiotic susceptibility test was done using the diffusion method. Biofilm formation was evaluated with microplate method using TTC. Bacteremia caused by Proteus spp. was found in 97 patients, mainly secondary to urinary tract infection. Most of the strains were susceptible to piperacillin with tazobactam (95.9%) and amikacin (86.7%). Elderly patients have a higher risk of mortality after BSIs caused by Proteus spp. A detailed analysis was made for randomly chosen 26 strains isolated from 11 patients with Proteus mirabilis bacteremia. Using PFGE, we found that 10 (90.9%) isolates, collected from different clinical specimens of the same patient, were genetically identical.

Proteus spp. is an etiological factor of urinary tract and bloodstream infections. The aim of this study was the retrospective analysis of susceptibility of Proteus spp. strains isolated from bloodstream infections (BSIs) as well as similarity evaluation of the strains isolated from different clinical samples. Proteus spp. strains were isolated in 2009–2017 from hospital patients. Identification was based on the colony’s morphology and biochemical or MALDI-TOF MS analyzes. The antibiotic susceptibility test was done using the diffusion method. Biofilm formation was evaluated with microplate method using TTC. Bacteremia caused by Proteus spp. was found in 97 patients, mainly secondary to urinary tract infection. Most of the strains were susceptible to piperacillin with tazobactam (95.9%) and amikacin (86.7%). Elderly patients have a higher risk of mortality after BSIs caused by Proteus spp. A detailed analysis was made for randomly chosen 26 strains isolated from 11 patients with Proteus mirabilis bacteremia. Using PFGE, we found that 10 (90.9%) isolates, collected from different clinical specimens of the same patient, were genetically identical.

Keywords: antimicrobial susceptibility; bacteremia; biofilm, Proteus spp..

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Conflict of interest statement

Conflict of interest

Author does not report any financial or personal connections with other persons or organizations, which might negatively affect the contents of this publication and/or claim authorship rights to this publication.

Figures

Fig. 1.
Fig. 1.
The Dienes phenomenon: A) non-identical strains, B) identical strains.
Fig. 2.
Fig. 2.
Antibiotic susceptibility of ESBLs(+) and ESBLs(–) Proteus spp. strains (n = 98) isolated from bacteremia; p-value of chi2 testing between susceptible and non-susceptible (resistant and intermediate) strains; abbreviations of antibiotic names (see Table III).
See this image and copyright information in PMC

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