Clonal Dissemination of NDM-Producing <em>Proteus mirabilis</em> in a Teaching Hospital in Sousse, Tunisia
Nadia Jaidane,
Lamia Tilouche,
Saoussen Oueslati,
Delphine Girlich,
Sana Azaiez,
Aymeric Jacquemin,
Laurent Dortet,
Walid Naija,
Abdelhalim Trabelsi,
Thierry Naas,
Wejdene Mansour,
Rémy A. Bonnin
Affiliations
Nadia Jaidane
Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse 4000, Tunisia
Lamia Tilouche
Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse 4000, Tunisia
Saoussen Oueslati
Team ‘Resist’, UMR1184 ‘Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB)’, INSERM, Université Paris-Saclay, CEA, LabEx LERMIT, Faculty of Medicine, 94270 Le Kremlin-Bicêtre, France
Delphine Girlich
Team ‘Resist’, UMR1184 ‘Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB)’, INSERM, Université Paris-Saclay, CEA, LabEx LERMIT, Faculty of Medicine, 94270 Le Kremlin-Bicêtre, France
Sana Azaiez
Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse 4000, Tunisia
Aymeric Jacquemin
Team ‘Resist’, UMR1184 ‘Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB)’, INSERM, Université Paris-Saclay, CEA, LabEx LERMIT, Faculty of Medicine, 94270 Le Kremlin-Bicêtre, France
Laurent Dortet
Team ‘Resist’, UMR1184 ‘Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB)’, INSERM, Université Paris-Saclay, CEA, LabEx LERMIT, Faculty of Medicine, 94270 Le Kremlin-Bicêtre, France
Walid Naija
Faculty of Medicine Ibn El Jazzar, University of Sousse, Sousse 4000, Tunisia
Abdelhalim Trabelsi
Clinical Microbiology Laboratory, University Hospital of Sahloul, Sousse 4002, Tunisia
Thierry Naas
Team ‘Resist’, UMR1184 ‘Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB)’, INSERM, Université Paris-Saclay, CEA, LabEx LERMIT, Faculty of Medicine, 94270 Le Kremlin-Bicêtre, France
Wejdene Mansour
Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse 4000, Tunisia
Rémy A. Bonnin
Team ‘Resist’, UMR1184 ‘Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB)’, INSERM, Université Paris-Saclay, CEA, LabEx LERMIT, Faculty of Medicine, 94270 Le Kremlin-Bicêtre, France
Proteus mirabilis (P. mirabilis) is an opportunistic pathogen involved in urinary tract infections as well as various nosocomial infections. Emerging resistances to beta-lactams in this species complicates potential treatment since it is intrinsically resistant to colistin. Eleven isolates of carbapenem-non-susceptible P. mirabilis were identified in Sousse Hospital, Tunisia, from January 2018 to December 2022. MICs were determined and isolates were sequenced to determine their resistomes, sequence types, virulence factors, and their clonal relationships. Susceptibility testing showed that all isolates were resistant to carbapenems, aminoglycosides, fluoroquinolones, chloramphenicol, and the trimethoprim/sulfamethoxazole combination. They remained susceptible to the aztreonam/avibactam combination. All isolates produced NDM-1 carbapenemase and ArmA 16S rRNA methylase. In addition, one isolate co-produced the blaVEB-6 gene. All isolates belonged to ST135, and phylogenetic analysis revealed that they were closely related. This study described the first outbreak of NDM-1-producing P. mirabilis in Tunisia.
