# Insights into novel diagnostic assay development, antimicrobial resistance, and pathogenicity in Proteus mirabilis through pan-genome analysis

## TL;DR

This study uses pan-genome analysis to identify unique genes in Proteus mirabilis, develop accurate PCR tests, and understand its increasing antibiotic resistance and virulence.

## Contribution

Identification of species-specific core genes and development of PCR assays for accurate detection of P. mirabilis.

## Key findings

- Two species-specific core genes, PMI3020 and PMI3598, were identified as molecular targets for PCR assays.
- P. mirabilis has a higher abundance of AMR genes, leading to increased resistance to carbapenems and cephalosporins.
- TaqMan probe-based real-time PCR showed high sensitivity (3.43 × 10² CFU/mL) for P. mirabilis detection.

## Abstract

Proteus mirabilis, a significant pathogen associated with human urinary tract infections (UTIs), demonstrates escalating multidrug resistance (MDR) that complicates clinical management. Accurate identification and in-depth genomic analysis are essential for monitoring and controlling this pathogen. This study aimed to identify the species-specific gene repertoire, antimicrobial resistance (AMR), and virulence genetic profiles through pan-genome analysis to develop novel detection methods and better understand emerging public health threats. The genus Proteus exhibits an open pan-genome, with P. mirabilis harboring a distinct species-specific gene repertoire. Two species-specific core genes, PMI3020 and PMI3598, were identified as molecular targets. We developed conventional PCR and TaqMan probe-based real-time PCR assays, which demonstrated high specificity when tested against P. mirabilis and non-P. mirabilis isolates. The TaqMan probe-based real-time PCR demonstrated a sensitivity of 3.43 × 10² CFU/mL using serial dilutions of P. mirabilis DNA. Comparative genomic analysis revealed significant differences in AMR and pathogenicity-related gene repertoires between P. mirabilis and other Proteus spp. The higher prevalence of AMR phenotypes in P. mirabilis correlated with its greater abundance of AMR genes. Emerging AMR genes acquired through horizontal gene transfer (HGT) have increased MDR risks, particularly to carbapenems and cephalosporins. Additionally, P. mirabilis genomes contain more virulence genes mainly related to adherence and iron acquisition. Our findings establish pan-genome analysis as an effective tool for identifying specific genetic markers to detect pathogens accurately and provide a comprehensive genomic framework illuminating AMR dynamics and virulence in P. mirabilis, thereby providing a valuable foundation for future public health risk assessments.

P. mirabilis is a major uropathogen with increasing AMR prevalence. The dissemination of AMR genes across healthcare and community settings poses critical challenges to infection control. This study conducted pan-genome analysis of Proteus to identify P. mirabilis-specific gene repertoire, of which species-specific core genes were used as molecular targets to develop highly sensitive PCR assays for accurate detection of this pathogen. Compared with other Proteus spp., P. mirabilis possesses a greater abundance of AMR genes, resulting in a higher prevalence of AMR phenotypes, including significant resistance to carbapenems and cephalosporins. This study establishes pan-genome analysis as an effective strategy for mining species-specific genetic markers, enabling the development of novel PCR assays for accurate pathogen detection. The comprehensive genomic framework enhances understanding of AMR dynamics and virulence mechanisms essential for public health risk assessment.