Background and Aim: Proteus mirabilis, an opportunistic pathogen of the Enterobacteriaceae family, is frequently implicated in wound infections and exhibits significant antibiotic resistance, particularly through the production of extended-spectrum beta-lactamase (ESBL). This study aimed to determine the occurrence and antibiotic susceptibility of ESBL-producing and non-ESBL P. mirabilis isolates in wound infections at Zainoel Abidin General Hospital, Banda Aceh, Indonesia.

Materials and Methods: A cross-sectional study was conducted on wound specimens collected between January 2021 and March 2024. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK® 2 Compact system. Statistical analyses were conducted using Chi-square or Fisher statistical analyses significance set at p ≤ 0.05.

Results: A total of 153 P. mirabilis isolates were identified, of which 60 (39.22%) were ESBL-producing and 93 (60.78%) were non-ESBL-producing. The highest occurrence was observed in male patients (55% ESBL and 54.84% non-ESBL) and in patients older than 55 years (48.33% ESBL and 38.71% non-ESBL). Antibiotic susceptibility testing revealed that ESBL-producing isolates were highly susceptible to cefoperazone/sulbactam (98.67%), meropenem (98.33%), amikacin (96.67%), and piperacillin/tazobactam (91.67%). Non-ESBL isolates exhibited the highest susceptibility to amikacin (97.85%), cefoperazone/sulbactam (96.77%), piperacillin/tazobactam (91.67%), and ceftazidime (90.32%). Notably, ESBL-producing isolates exhibited resistance to amoxicillin (0%), ampicillin (1.67%), cefotaxime (8.33%), and levofloxacin (10%).

Conclusion: The high occurrence of ESBL-producing P. mirabilis, particularly in elderly patients, underscores the need for routine ESBL screening and targeted antibiotic therapy. The observed differences in antibiotic susceptibility between ESBL and non-ESBL isolates highlight the importance of early detection for appropriate antibiotic selection in wound infection management. Continued surveillance and antimicrobial stewardship are crucial in mitigating the impact of antibiotic-resistant P. mirabilis in clinical settings.

Keywords: antibiotic resistance, antimicrobial susceptibility, extended-spectrum beta-lactamase, Proteus mirabilis, wound infection.

How to cite this article: Suhartono S, Hayati Z, Mahdani W, and Fonna J (2025) Comparative distribution and antibiotic susceptibility of extended-spectrum beta-lactamase- and non-extended-spectrum beta-lactamase-producing Proteus mirabilis in wound infections at Zainoel Abidin General Hospital, Banda Aceh, Indonesia, Int. J. One Health, 11(1): 54-61.

Received: 15-10-2024    Accepted: 07-02-2025    Published online: 11-03-2025

Corresponding author: Suhartono Suhartono    E-mail: suhartono@usk.ac.id

DOI: 10.14202/IJOH.2025.54-61

Copyright: Suhartono, et al. This article is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/ by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.