Molecular characterization of multidrug-resistant Proteus mirabilis isolates from pregnant women with recurrent urinary tract infection in Erbil city, Iraq.

BACKGROUND AND

OBJECTIVES

Urinary tract infections (UTIs) are common in pregnancy and can cause maternal and fetal complications. Proteus mirabilis is a significant pathogen in recurrent UTIs due to its virulence factors. This study investigated the virulence genes and antibiotic resistance patterns of P. mirabilis isolates from pregnant women with UTIs in Erbil, Iraq.

MATERIALS AND

METHODS

This cross-sectional study (September 2024-January 2025) included 120 urine specimens from pregnant women (15-44 years) with UTI symptoms. Bacterial identification was performed using culture, biochemical tests, as well as the Vitek 2 system. Virulence genes were detected by PCR, and antimicrobial susceptibility was assessed by standard methods.

RESULTS

Of the 120 samples, 103 (85.8%) showed bacterial growth; 8 (6.7%) were positive for P. mirabilis, while 95 (79.1%) yielded other bacteria. The most affected age group was 25-34 years (52.5%), predominantly in the second trimester (42.5%) and urban residents (60.8%). Antimicrobial resistance was significant to ampicillin, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid, and cephalosporins, although susceptibility was observed with several antibiotics. All P. mirabilis isolates harbored the UreC gene, and 75% possessed the MrpA virulence gene.

CONCLUSION

Multidrug-resistant P. mirabilis with key virulence genes was detected in pregnant women with UTIs. Regular screening and resistance monitoring are essential for effective management.