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Fluoroquinolone-Resistant Proteus Mirabilis
As with other Enterobacteriaceae, fluoroquinolone resistance saw three-fold increase since 1999
BACKGROUND
Proteus mirabilis is a member of the Enterobacteriaceae family of bacteria, along with E. coli and K. pneumoniae, which together account for the vast majority of community-acquired urinary tract infections (UTIs). P. mirabilis comensally inhabits the gastrointestinal tract without causing disease. However, when it colonizes sterile parts of the body, it can be difficult to eliminate because of its tendency to produce a biofilm of mineral deposits (e.g., kidney stones).
Fluoroquinolones are the most frequently prescribed drug class in the United States and are also indicated as first-line drugs for uncomplicated UTIs when local trimethophrim-sulfa resistance is known to be high. Rising fluoroquinolone resistance is worrisome because it has been linked to the emergence of plasmid-mediated quinolone resistance (PMQR), a mechanism by which genes that encode for resistance are transmitted horizontally (from one organism to another) rather than vertically (from parent organism to offspring), thus accelerating the rate at which all Enterobacteriaceae develop resistance.
RESISTANCE BY U.S. CENSUS DIVISION, 1999-2010
