Open AccessPathogenesis of <b><i>Proteus mirabilis</i></b> in Catheter-Associated Urinary Tract Infections
Author(s) -
Fei Yuan,
Zhuowei Huang,
Tongxin Yang,
Guang Wang,
Pei Li,
Bowei Yang,
Jiongming Li
Publication year - 2021
Publication title -
urologia internationalis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.771
H-Index - 53
eISSN - 1423-0399
pISSN - 0042-1138
DOI - 10.1159/000514097
Subject(s) - proteus mirabilis , medicine , urinary system , microbiology and biotechnology , catheter , swarming motility , bacterial adhesin , pathogenesis , bladder stones , biofilm , immunology , virulence , bacteria , biology , surgery , pseudomonas aeruginosa , quorum sensing , biochemistry , genetics , gene
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.