DETECTION of PROTEUS SPECIES in DIABETIC WOUNDS and THEIR ANTIBIOTIC RESISTANCE PROFILE ANALYSIS

Abstract

This work was carried out to determine the incidence of Proteus species infection in patients had diabetic foot wounds admitted to Vascular Surgery Department at Assiut University Hospitals. Proteus isolates were the most isolated organism (37.73%) followed by Klebsiella spp. (22.64%), then Pseudomonas spp. (20.75%) and E. coli (18.87%). Proteus mirabils was the most isolated species represented (78%) followed by Proteus vulgaris (13%) then Proteus penneri (9%). The antimicrobial susceptibility patterns of the isolated Proteus spp. were determined using agar disk diffusion method. The highest sensitivity was to ertapenem 76 isolates (76%). The antibiotic sensitivity then decrease in descending manner to be amikacin (65%) > meropenem (54%) > imipenem (52%) > cefipime (49%), while the highest resistance rates were to amoxicillin–clavulanic acid 75 isolates (75%) > co-trimoxazole (73%) > cefoxitin (63%) > ciprofloxacin (49%). Plasmid DNA profile analysis of 10 MDR Proteus mirabilis that were common resistant to ceftriaxone was studied. Plasmid bands of six resistant Proteus mirabilis isolates were shown at 800bp while the others at 700 bp. Plasmid curing was done by EtBr and SDS. Results of plasmid curing using ethidium bromide sublethal concentration of EtBr 1.25% showed that 7 cured cells become sensitive to ceftriaxone (30 µg), while 3 non cured cell still resistant to ceftriaxone. Plasmid curing using SDS sublethal concentration of SDS 1.2% cured only one of ten Proteus mirabilis which become sensitive to ceftriaxone and lost its band at 800bp, the other Proteus mirabilis not cured by SDS.