Proteus mirabilisbiofilms and catheter-associated urinary tract infections

Abstract

Proteus mirabilis inhabits the environment and causes a number of infections including those of the skin, respiratory tract, wounds and urinary tract. These organisms express virulence factors associated with adhesion, motility, immunoavoidance, nutrient acquisition, host damage, as well as biofilm formation. P. mirabilis produces biofilms in diverse habitats with those formed in the human host playing a key role in indwelling device infections. The most studied P. mirabilis biofilms are those formed when the organism is grown in urine, resulting in unique features including the presence of swarmer cells and struvite and hydroxyapatite crystals upon growth in urine. Factors relevant to P. mirabilis biofilm formation include adhesion factors, proteins involved in LPS production, transporters, transcription factors, two component systems, communication factors and enzymes. P. mirabilis biofilm research will lead to a better understanding of the disease process and will subsequently lead to the development of new prevention, and treatment options.

The potential of photo-deposited silver coatings on Foley catheters to prevent urinary tract infections

“…The bacterial pathogens most commonly associated with catheter-associated urinary tract infections (CAUTIs) are Escherichia coli and Proteus mirabilis [4]. An infection associated with Proteus mirabilis frequently leads to blockage of catheters because of biomineralisation and formation of a crystalline biofilm through the bioconversion of urinary ammonium and other salts, causing obstruction of catheter lumen and kidney infection and septicaemia [4][5][6]. Klebsiella pneumoniae is a gastro-intestinal bacterium and an opportunistic pathogen associated with septicaemia, pneumonia, urinary tract infections, and meningitis, and can persist within the urinary tract despite appropriate antibiotic treatments [7].…”

The role of bacterial hypermutation in biofilm formation and antibiotic resistance in urinary tract infections caused by pathogens of the Enterobacteriaceae family

“…As expected with the urease producer Proteus mirabilis, previously described as the predominant organism in biofilms from encrusted catheters [55] and urinary stones, 10/10 (100%) and 0/8 were biofilm producers in UTIs and BSIs, respectively (P < 0.001). Nevertheless, 7 out of 10 isolates of P. mirabilis from UTIs showed a weak mutator phenotype, all of which were biofilm producers in a different level (one was +biofilm producer, five were ++biofilm producers, and two were +++biofilm producers).…”

Design, synthesis and evaluation of peptides and peptidomimetics inhibiting the bacterial DsbA-DsbB interaction

“…Together, the Enterobacteriaceae account for the vast majority of community-acquired and nosocomial urinary tract infections (UTIs) (Guay, 2008, Ronald, 2003. P. mirabilis is a frequent cause of both complicated and catheter-associated UTIs (Jacobsen et al, 2008, Jacobsen & Shirtliff, 2011.…”

“…mirabilis associated infections are often difficult to treat due to its propensity to form biofilms (Jacobsen & Shirtliff, 2011). Two cell surface organelles associated with P. mirabilis biofilm formation, mannose-resistant Proteus-like (MR/P) fimbriae (Jansen et al, 2004) and flagella (which mediate swarming) (Jacobsen & Shirtliff, 2011), require DsbA for their correct assembly. Taken together, our data show that PmDsbA exhibits redox, functional and structural properties typical of the DsbA class Ia enzymes which extends to all DsbAs characterized to date from Enterobacteriaceae .…”

“…Together, the Enterobacteriaceae account for the vast majority of community-acquired and nosocomial urinary tract infections (UTIs) (Guay, 2008, Ronald, 2003. P. mirabilis is a frequent cause of both complicated and catheter-associated UTIs (Jacobsen et al, 2008, Jacobsen & Shirtliff, 2011.Multidrug resistant strains of clinical pathogenic P. mirabilis have been reported for several decades (Guay, 2008). For example clinical isolates of P. mirabilis resistant to streptomycin, tetracycline, kanamycin, chloramphenicol and polymyxin B were described in the 1960s (Coetzee & Sacks, 1960, Sabath, 1969 and reports of antibiotic resistance have increased since then (Pearson et al, 2008, Hitchings, 1973, Wellington et al, 2013, Elsea et al, 1992, Tibbetts et al, 2008, Mehtar et al, 1991, Franklin & Rownd, 1973, Coetzee, 1975, Zhao & Hu, 2013.…”