AUTHOR=Girlich Delphine , Bonnin Rémy A. , Dortet Laurent , Naas Thierry 

TITLE=Genetics of Acquired Antibiotic Resistance Genes in Proteus spp.

JOURNAL=Frontiers in Microbiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2020.00256

DOI=10.3389/fmicb.2020.00256

ISSN=1664-302X

ABSTRACT=<p><italic>Proteus</italic> spp. are commensal Enterobacterales of the human digestive tract. At the same time, <italic>P. mirabilis</italic> is commonly involved in urinary tract infections (UTI). <italic>P. mirabilis</italic> is naturally resistant to several antibiotics including colistin and shows reduced susceptibility to imipenem. However higher levels of resistance to imipenem commonly occur in <italic>P. mirabilis</italic> isolates consecutively to the loss of porins, reduced expression of penicillin binding proteins (PBPs) PBP1a, PBP2, or acquisition of several antibiotic resistance genes, including carbapenemase genes. In addition, resistance to non-β-lactams is also frequently reported including molecules used for treating UTI infections (e.g., fluoroquinolones, nitrofurans). Emergence and spread of multidrug resistant <italic>P. mirabilis</italic> isolates, including those producing ESBLs, AmpC cephalosporinases and carbapenemases, are being more and more frequently reported. This review covers <italic>Proteus</italic> spp. with a focus on the different genetic mechanisms involved in the acquisition of resistance genes to multiple antibiotic classes turning <italic>P. mirabilis</italic> into a dreadful pandrug resistant bacteria and resulting in difficult to treat infections.</p>