7 Document heading doi:10.1016/S2222-1808(12)60003-6 Nosocomial and community acquired uropathogenic isolates of Proteus mirabilis and antimicrobial susceptibility profiles at a university hospital in Sub-Saharan Africa Jombo GTA 1 , Emanghe UE 2 , Amefule EN 2 , Damen JG 3 1 Department of Medical Microbiology and Parasitology, College of Health Sciences, Benue State University, PMB 102119 Makurdi, Nigeria 2 Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital, Calabar, Nigeria 3 Department of Medical Laboratory Science, Faculty of Medical Sciences, University of Jos PMB 2084 Jos, Nigeria Asian Pacific Journal of Tropical Disease (2012)7-11 Asian Pacific Journal of Tropical Disease journal homepage:www.elsevier.com/locate/apjtd *Corresponding author: Jombo GTA, Department of Medical Microbiology and Parasitology, College of Health Sciences, Benue State University, PMB 102119 Makurdi, Nigeria. Tel: +2348039726398 E-mail; jombogodwin@yahoo.com 1. Introduction Proteus mirabilis ( P. mirabilis ) , a member of the Enterobacteriaceae is often considered to be implicated in contaminations and colonizations [1,2] . The organism is also often linked with several pyogenic infections and has been strongly associated with urinary tract infections (UTIs) among humans [3-5] . The different types of fimbriae expressed by the organisms such as PmfA, PmfC, PmfD, Pmf E and Pmf F play cardinal roles in colonization of urinary bladder and urethra and are believed to contribute to the pathogenesis of UTI among humans [6-8] . The rapid mutation of the virulent genes of Proteus species generally has also been attributed to its immunological evasion and pathogenicity in the urinary pathway as well as its ability to withstand the acidic microenvironment of the genitourinary tract [9,10] . Over the last decade, treatment of infections caused by P. mirabilis have often been accompanied by varied and mixed outcomes [11,12] . In USA isolates of P. mirabilis from infections lesions were all found to be beta- lactamase producing and were also resistant to ampicillin, gentamicin, ceftazidime, cefotaxime, cefuroxime, cefalothin, cefepime, piperacillin, trimethoprim/sulphamethoxazole and ciprofloxacin [13] . Also in Italy, a prolonged form of bacteremia difficult to treat with majority of the commonly available antibiotics as found to be caused by VIM-1 metallo-beta-lactamase-producing P. mirabilis [14} . Furthermore, in Poland, 10.4%-18.7% ESPL P. mirabilis strains principally from urine were isolated at a university hospital over a three year period showing high multiple resistance to over four antimicrobials in common use [15] . P. mirabilis from UTIs was similarly found to show high multiple resistance against all the common antimicrobials in Greece, Nigeria and Portugal [16-18] . ARTICLE INFO ABSTRACT Article history: Received 10 November 2011 Received in revised form 16 November 2011 Accepted 2 December 2011 Available online 28 February 2012 Keywords: Antimicrobial susceptibility patterns Proteus mirabilis Urinary tract infections Nosocomial Comunity aquired Sub-Saharan Africa Objective: To ascertain antimicrobial susceptibility profile of Proteus mirabilis (P. mirabilis) from clinical urine specimens at a university hospital in the spate of its recorded increasing resistance patterns.Methods: The study was retrospective in nature. Data generated from urine cultures of patients at University of Calabar Teaching Hospital for a period of five years (2004-2009) were compiled. Relevant information obtained were age and gender of patients, organisms recovered and their antibiotic susceptibility patterns. P. mirabilis was identified using standard laboratory procedures. Results: P. mirabilis showed the highest resistance against ampicillin, cloxacillin, amoxicillin, tetracycline, co-trimoxazole, erythromycin and chloramphenicol (100%-37.2%) while colistin, ofloxacin, ciprofloxacin, ceftriaxone, nalidixic acid and nitrofurantoin recorded the highest activity (59.1%-96.9%) with no drug recording 100% activity. The resistance of the nosocomial isolates of the organism were significantly higher than the community acquired isolates against that of the common antibiotics in use (P<0.05). Conclusions: Extreme caution should be exercised in antibiotic administration in hospital setting and the potential benefits adequately assessed while control of nosocomial infections be given a priority so as to limit the spread of resistant bacteria. Contents lists available at ScienceDirect