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Background <p><i>Proteus mirabilis</i> is an important opportunistic pathogen in healthcare settings, but data from secondary-care hospitals in Oman remain limited.</p> Objective <p>The aim of this study was to describe the epidemiology and antimicrobial resistance profile of laboratory-confirmed <i>P. mirabilis</i> infections in a secondary-care hospital in Oman and to identify predictors of multidrug-resistant organism (MDRO) infection and in-hospital mortality.</p> Methods <p>We conducted a retrospective cross-sectional study at Sohar Hospital, Oman, including all laboratory-confirmed <i>P. mirabilis</i> infection episodes from January to December 2022. After episode-level deduplication, 193 unique infection episodes were analysed. Demographic, clinical and microbiological data were extracted from hospital records. Antimicrobial susceptibility testing was interpreted according to CLSI criteria. Univariable and multivariable logistic regression analyses were performed to identify predictors of MDRO infection and in-hospital mortality.</p> Results <p>The cohort was predominantly male (64.8%) with a median age of 63 years. Wound swabs were the most common specimen source (53.4%), followed by urine (22.3%) and endotracheal secretions (13.0%). MDRO prevalence was 39.4%, comprising ESBL-producing isolates (14.0%), CRE (12.4%) and MDR-only phenotypes (13.0%). In-hospital mortality was 26.4% and was higher in MDRO-positive than non-MDRO infections (38.2% vs. 18.8%). Third-generation cephalosporins showed very poor activity among tested isolates, whereas piperacillin-tazobactam retained the best susceptibility among adequately tested agents. Male sex independently predicted MDRO infection (aOR 3.81). Any comorbidity (aOR 13.56), ICU admission (aOR 8.43) and MDRO infection (aOR 2.66) independently predicted mortality.</p> Conclusions <p>In this single-centre secondary-care cohort, <i>P. mirabilis</i> infections showed a substantial MDRO burden and clinically important in-hospital mortality. These findings support strengthened surveillance, antimicrobial stewardship and targeted infection-prevention measures, particularly in clinically documented wound-care and critical-care settings, while recognising the retrospective design and absence of molecular resistance confirmation.</p>

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Proteus mirabilis infections in a secondary-care hospital in Oman: epidemiology, antimicrobial resistance, and predictors of in-hospital mortality

  • 期刊论文

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  • 发表日期：

    2026年6月26日

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  • Mohan Bilikallahalli Sannathimmappa,
  • Vinod Nambiar,
  • Salima Al-Maqbali

摘要

Background

Proteus mirabilis is an important opportunistic pathogen in healthcare settings, but data from secondary-care hospitals in Oman remain limited.

Objective

The aim of this study was to describe the epidemiology and antimicrobial resistance profile of laboratory-confirmed P. mirabilis infections in a secondary-care hospital in Oman and to identify predictors of multidrug-resistant organism (MDRO) infection and in-hospital mortality.

Methods

We conducted a retrospective cross-sectional study at Sohar Hospital, Oman, including all laboratory-confirmed P. mirabilis infection episodes from January to December 2022. After episode-level deduplication, 193 unique infection episodes were analysed. Demographic, clinical and microbiological data were extracted from hospital records. Antimicrobial susceptibility testing was interpreted according to CLSI criteria. Univariable and multivariable logistic regression analyses were performed to identify predictors of MDRO infection and in-hospital mortality.

Results

The cohort was predominantly male (64.8%) with a median age of 63 years. Wound swabs were the most common specimen source (53.4%), followed by urine (22.3%) and endotracheal secretions (13.0%). MDRO prevalence was 39.4%, comprising ESBL-producing isolates (14.0%), CRE (12.4%) and MDR-only phenotypes (13.0%). In-hospital mortality was 26.4% and was higher in MDRO-positive than non-MDRO infections (38.2% vs. 18.8%). Third-generation cephalosporins showed very poor activity among tested isolates, whereas piperacillin-tazobactam retained the best susceptibility among adequately tested agents. Male sex independently predicted MDRO infection (aOR 3.81). Any comorbidity (aOR 13.56), ICU admission (aOR 8.43) and MDRO infection (aOR 2.66) independently predicted mortality.

Conclusions

In this single-centre secondary-care cohort, P. mirabilis infections showed a substantial MDRO burden and clinically important in-hospital mortality. These findings support strengthened surveillance, antimicrobial stewardship and targeted infection-prevention measures, particularly in clinically documented wound-care and critical-care settings, while recognising the retrospective design and absence of molecular resistance confirmation.