Journal
UROLOGIA INTERNATIONALIS
Volume 105, Issue 5-6, Pages 354-361Publisher
KARGER
DOI: 10.1159/000514097
Keywords
Urinary tract infections; Proteus mirabilis; Catheter-associated urinary tract infections; Catheters; Pathogenesis
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Funding
- Yunnan Provincial Science and Technology Department/Kunming Medical University Joint Project of Basic Research [2019FE001(-149), 202001AY070001-062]
- Yunnan Medical Science Specialist Training Project [H-2017045]
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Proteus mirabilis, a Gram-negative rod-shaped bacterium, is widely present in the natural environment and is most noted for its swarming motility and urease activity. It is the main pathogen causing complicated UTIs, especially catheter-associated UTIs, and forms crystalline biofilms on catheters. The bacterium can lead to various urinary tract infections and fatal complications through different virulence factors.
Proteus mirabilis (PM) is a Gram-negative rod-shaped bacterium and widely exists in the natural environment, and it is most noted for its swarming motility and urease activity. PM is the main pathogen causing complicated urinary tract infections (UTIs), especially catheter-associated urinary tract infections. Clinically, PM can form a crystalline biofilm on the outer surface and inner cavity of the urethral indwelling catheter owing to its ureolytic biomineralization. This leads to catheter encrustation and blockage and, in most cases, is accompanied by urine retention and ascending UTI, causing cystitis, pyelonephritis, and the development of bladder or kidney stones, or even fatal complications such as septicemia and endotoxic shock. In this review, we discuss how PM is mediated by a catheter into the urethra, bladder, and then rose to the kidney causing UTI and the main virulence factors associated with different stages of infection, including flagella, pili or adhesins, urease, hemolysin, metal intake, and immune escape, encompassing both historical perspectives and current advances.
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