mirabilis is a leading agent of pyelonephritis, urolithiasis, prostatitis and catheter-associated urinary tract infections (CAUTIs) and causes approximately 3% of all nosocomial infections and up to 44% of CAUTIs in the United States 4, 5, 6.ĬAUTIs are the most common health care-associated infections worldwide, accounting for up to 40% of hospital-acquired infections 7. Members of the genus Proteus are widely distributed in nature and can be isolated from soil, stagnant water, sewage and the intestinal tract 3.
![proteus (bacterium) proteus (bacterium)](http://article.sapub.org/image/10.5923.j.microbiology.20150504.02_001.gif)
Proteus mirabilis, a Gram-negative, dimorphic, motile member of the family Enterobacteriaceae, has fascinated scientists for more than 125 years owing to its ability to differentiate from short rods into elongated, multinucleate swarm cells that express thousands of flagella 2. The name Proteus was first used in bacterial nomenclature by Hauser in 1885 to describe a shape-shifting bacterium isolated from putrefied meat 1. In Homer's Odyssey, Proteus was pursued by many for his ability to foretell the future to anyone capable of capturing him, but he changed shape to evade his pursuers. mirabilis that make this bacterium a successful agent of CAUTIs, as well as the multitude of ways in which this species might enhance the persistence or pathogenicity of other common uropathogens, there is a pressing need to better understand the interactions occurring between CAUTI pathogens on the catheter and during the UTI. The ammonia produced by the action of urease also has the potential to enhance the persistence of some bacterial species, whereas the resulting increase in pH has a detrimental effect on the persistence of other species. Crystalline biofilms and urinary stones that are formed as a result of urease activity facilitate bacterial entry to the urinary tract by obstructing urine flow and may also provide protection from the host immune respons, as well as from antimicrobial agents. mirabilis promotes polymicrobial infection and bacterial persistence within the urinary tract. In addition to these signals, conditions that favour the expression of any of 14 distinct fimbriae for adherence cause a reciprocal decrease in the expression of flagella to reduce motility. Regulation of swarm cell differentiation and swarming motility is highly complex and involves the integration of several signals, including the presence of a surface, cell membrane integrity and composition, nutritional status and the presence or absence of specific amino acids. This unique type of motility also facilitates migration of non-motile species colonizing the catheter. mirabilis uses swarming motility to migrate across the catheter surface.
![proteus (bacterium) proteus (bacterium)](https://previews.123rf.com/images/drmicrobe/drmicrobe1704/drmicrobe170400098/76197310-proteus-vulgaris-bacterium-3d-illustration-gram-negative-bacterium-with-causes-enteric-urinary-and-o.jpg)
mirabilis is exquisitely committed to survival within the host urinary tract, as this species has the greatest number of distinct fimbrial types of any sequenced organism, possesses the ability to generate and utilize an abundant nitrogen source in a nitrogen-limited environment, encodes at least 21 putative systems for iron acquisition in an iron-limited environment and produces an immunoglobulin A protease to evade the host humoral immune response. mirabilis can significantly affect the ability of other species to establish a UTI and that other species modulate P.
![proteus (bacterium) proteus (bacterium)](https://images.fineartamerica.com/images-medium-5/proteus-vulgaris-bacteria-sem-spl.jpg)
Few studies have focused on polymicrobial interactions during UTIs, but there is evidence that P. Proteus mirabilis is one of the leading causes of CAUTIs and is the most commonly isolated species from polymicrobial CAUTIs. Catheter-associated urinary tract infections (CAUTIs) are the most common health care-associated infections worldwide and are frequently polymicrobial.