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Pathogenesis of Proteus mirabilis in Catheter-Associated Urinary Tract Infections

Fei Yuan1, Ziye Huang1, Tongxin Yang1

  • 1Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.

Urologia Internationalis
|March 10, 2021
PubMed

Insights

Proteus mirabilis causes complicated urinary tract infections (UTIs), particularly catheter-associated UTIs, by forming crystalline biofilms. This review details its virulence factors and infection pathway from the urethra to the kidney.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Urology

Background:

  • Proteus mirabilis (PM) is a Gram-negative bacterium known for swarming motility and urease activity.
  • It is a primary pathogen in complicated urinary tract infections (UTIs), especially catheter-associated UTIs (CAUTIs).
  • PM's ureolytic biomineralization leads to crystalline biofilm formation on catheters, causing encrustation, blockage, and ascending infections.

Purpose of the Study:

  • To review the pathogenesis of Proteus mirabilis-induced UTIs.
  • To elucidate the role of PM in catheter encrustation and blockage.
  • To discuss the key virulence factors contributing to different infection stages.

Main Methods:

  • Literature review of Proteus mirabilis pathogenesis.
  • Analysis of virulence factors involved in UTI development.
  • Examination of the pathway of infection from urethra to kidney.

Main Results:

  • PM utilizes urease activity for biomineralization and biofilm formation on urinary catheters.
  • Catheter encrustation by PM leads to complications like urine retention, ascending UTIs, and stone formation.
  • Virulence factors include flagella, pili, urease, hemolysin, metal uptake, and immune evasion strategies.

Conclusions:

  • Proteus mirabilis poses a significant threat in CAUTIs due to its unique virulence mechanisms.
  • Understanding these factors is crucial for developing effective prevention and treatment strategies.
  • This review synthesizes current knowledge on PM pathogenesis and virulence, highlighting areas for future research.
Keywords:
Catheter-associated urinary tract infectionsCathetersPathogenesisProteus mirabilisUrinary tract infections

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