Antibiotic susceptibility testing of Proteus mirabilis isolates from selected hospitals in Anbar governorate, Iraq

Abstract

Objective: To investigate the antibiotic susceptibility profiles of Proteus mirabilis isolated from clinical samples in selected hospitals in Anbar Governorate, Iraq.

Methods: A cross-sectional study was conducted from September 2024 to January 2025. A total of 255 clinical samples were collected from patients attending Al-Ramadi Teaching Hospital, Hit General Hospital, and private clinics. Isolation and identification of P. mirabilis were performed using conventional biochemical methods and confirmed with the Vitek-2 Compact system. Antibiotic susceptibility testing was conducted via the Kirby-Bauer disk diffusion method according to CLSI 2024 guidelines. Data were analysed descriptively, and chi-square tests were used to assess demographic associations.

Results: Out of 255 samples, 15 (5.88%) yielded P. mirabilis. Isolates showed 100% sensitivity to carbapenems (meropenem, imipenem, and ertapenem). High resistance was noted to cefotaxime (100%), ceftriaxone (73.3%), and piperacillin (86.6%). Moderate susceptibility was observed for amikacin (53.3%) and ciprofloxacin (46.6%). Infections were more prevalent in males (73.3%), urban residents (66.7%), and individuals aged 11–20 years (33.3%). A significant association was found between gender and infection status (p < 0.05).

Conclusion: Proteus mirabilis isolates in Anbar Governorate exhibit high resistance to third-generation cephalosporins but retain full susceptibility to carbapenems. These findings underscore the urgent need for local antimicrobial resistance surveillance and implementation of stewardship programs. Clinicians should exercise caution in empirical antibiotic selection and prioritise culture-based therapy to minimise resistance spread.