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In addition to being a leading cause of urinary tract infections (UTI), P. It can be found in soil, water, and the intestinal tract of mammals, including humans. Proteus mirabilis belongs to the Enterobacteriaceae family with the features of swarming motility and production of urease to generate ammonia. Continuous surveillance on antimicrobial resistance and associated resistance mechanisms in P. Cefotaxime was a better surrogate than ceftazidime for predicting the presence of these β-lactamases. The prevalence of ESBL remained stable but AmpC β-lactamase-producing P. mirabilis from Taiwan in the past decade. ConclusionsĪ significant decrease in susceptibility to 3rd-generation cephalosporins and ciprofloxacin occurred in P. The predominant ESBL and AmpC β-lactamase genes were CTX-M- and CMY- types, respectively. ESBL and AmpC β-lactamase-producers were more likely to be found in elderly and ICU patients. The overall prevalence of ESBL- and AmpC- producers was 8.2% and 4.7%, respectively, but AmpC carriage increased significantly over the years (from 0 to 7.0%, P < 0.001). Susceptibilities of isolates from different specimen types were mostly similar but outpatient isolates were more susceptible than inpatient isolates. However, using the 2014 cefazolin breakpoints for urinary tract infections, 81.2% of the urine isolates were susceptible. The revised CLSI breakpoints had significant impact on susceptibility to cefazolin (2009 vs. Susceptibility to cefotaxime, ceftazidime, and ciprofloxacin decreased significantly during the past decade, from 92.6% to 81.7%, 100% to 95.2%, and 80.1% to 53.8%, respectively ( P < 0.01). Univariate and multivariate analyses were performed. All isolates with aztreonam, ceftazidime, or cefotaxime MIC ≥ 2 mg/L were checked for the presence of ESBL by CLSI confirmatory test and subjected to ESBL and AmpC β-lactamases gene detection by PCR. Minimum inhibitory concentrations (MIC) were determined by reference broth microdilution method. Isolates were collected biennially between 20 from 25 to 28 hospitals in Taiwan. The present study analyzed data from the Taiwan Surveillance of Antimicrobial Resistance program to address these issues. The effects of the revised Clinical and Laboratory Standards Institute (CLSI) β-lactam breakpoints on susceptibility rates and on detecting extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase-producers in this species are also seldom evaluated. Longitudinal nationwide data on antimicrobial susceptibility in Proteus mirabilis from different sources are rare.