Characterization of endemicProvidencia stuartii isolates from patients with urinary devices

Abstract

Providencia stuartii has emerged as a significant nosocomial urinary tract pathogen. An increase in the number of Providencia isolates from urine cultures prompted an investigation into the possibility of an outbreak due to this organism. A high proportion of patients studied had urinary devices. Four wards were screened at two time periods to ascertain the prevalence of Providencia stuartii in urine cultures. Biotype, serotype, antibiogram and plasmid content were determined for each Providencia isolate. Of 129 patients initially sampled 22.5% were found to harbor Providencia stuartii. Biotyping, serotyping and antibiograms indicated an epidemic strain was not present. Similar results were obtained when the wards were screened a second time, with 25.4% of urine cultures found to contain Providencia stuartii. By plasmid analysis the isolates could be grouped into one of ten profiles. A correlation could be made between urease activity and the presence of a large plasmid. No association however could be made between a particular plasmid profile and antibiogram. The data indicate that an epidemic strain of Providencia stuartii was not present. The source(s) of the endemic Providencia stuartii strains remain unknown.

Speciation, serotyping, antimicrobial sensitivity and plasmid content of Proteeae from the environment of calf-rearing units in South West England

“…stuartii were 0:25 and 0:52 (two occasions each), both of these serotypes have been reported as being amongst the six most common serotypes isolated in hospitals in Canada, USA and UK ). The same serotypes have also been reported from a more recent episode of nosocomial infection in the USA (Hollick et al 1984). There have been reports of only five different serotypes isolated from hospital patients in the UK, the second most commonly isolated serotype was 0:25, which was found in the calves studied by us Epidemiological Research Laboratory, 1977).…”

“…stuartii. (Hawkey, Bennet & Hawkey, 1984;Hollick et al 1984). Thus although plasmid profiles may be useful epidemiological markers, considerable care is required in using them to interpret the movement of strains.…”

“…stuartii, both species have been reported as causes of nosocomial infection in man and accounts of environmental isolation of these species are few (Williams et al 1983;Hawkey, 1984 t Number of isolates from milk filters indicated in parentheses. (Hollick et al 1984).…”

Porin self-association enables cell-to-cell contact in Providencia stuartii floating communities

“…Treatment of infections by P. stuartii is complicated by its intrinsically strong resistance to a wide range of antibiotics (4,(6)(7)(8) and by its ability to form biofilms. The latter may attach and grow on indwelling catheters (3,9,10) and on uroepithelial cells (11). Recently, we reported the microscopic characterization of P. stuartii plankton and biofilms and the unexpected finding that this species forms floating communities of cells in solution before its deposition as a surfaceattached biofilm (12).…”

Variable phenotypes of Providencia stuartii due to plasmid-encoded traits

“…1973, G218, p. 62) reported that the ability to ferment lactose and degrade urea could be transferred from Proteus rettgeri (now Providencia rettgeri) to Escherichia coli and Salmonella species and that the "Proteus" strain could spontaneously and irreversibly lose urease activity. Several other reports described the instability of the urease trait in P. stuartii (3,14), and conjugative transfer of urease in P. stuartii was later demonstrated by Grant et al (4) and was correlated with the presence of a high-molecular-weight plasmid by Hollick et al (9). P. stuartii is commonly resistant to many clinically useful antibiotics.…”