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2018 ; 8
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English Wikipedia
Pathogenesis of Proteus mirabilis Infection
#MMPMID29424333
Armbruster CE
; Mobley HLT
; Pearson MM
EcoSal Plus
2018[Feb]; 8
(1
): ä PMID29424333
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Proteus mirabilis, a Gram-negative rod-shaped bacterium most noted for its
swarming motility and urease activity, frequently causes catheter-associated
urinary tract infections (CAUTIs) that are often polymicrobial. These infections
may be accompanied by urolithiasis, the development of bladder or kidney stones
due to alkalinization of urine from urease-catalyzed urea hydrolysis. Adherence
of the bacterium to epithelial and catheter surfaces is mediated by 17 different
fimbriae, most notably MR/P fimbriae. Repressors of motility are often encoded by
these fimbrial operons. Motility is mediated by flagella encoded on a single
contiguous 54-kb chromosomal sequence. On agar plates, P. mirabilis undergoes a
morphological conversion to a filamentous swarmer cell expressing hundreds of
flagella. When swarms from different strains meet, a line of demarcation, a
"Dienes line," develops due to the killing action of each strain's type VI
secretion system. During infection, histological damage is caused by cytotoxins
including hemolysin and a variety of proteases, some autotransported. The
pathogenesis of infection, including assessment of individual genes or global
screens for virulence or fitness factors has been assessed in murine models of
ascending urinary tract infections or CAUTIs using both single-species and
polymicrobial models. Global gene expression studies performed in culture and in
the murine model have revealed the unique metabolism of this bacterium. Vaccines,
using MR/P fimbria and its adhesin, MrpH, have been shown to be efficacious in
the murine model. A comprehensive review of factors associated with urinary tract
infection is presented, encompassing both historical perspectives and current
advances.
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