From Catheter to Kidney Stone: The Uropathogenic Lifestyle of Proteus mirabilis

Abstract

Proteus mirabilis is a model organism for urease-producing uropathogens. These diverse bacteria cause infection stones in the urinary tract and form crystalline biofilms on indwelling urinary catheters, frequently leading to poly-microbial infection. Recent work has elucidated how P. mirabilis causes all of these disease states. Particularly exciting is the discovery that this bacterium forms large clusters in the bladder lumen that are sites for stone formation. These clusters, and other steps of infection, require two virulence factors in particular: urease and MR/P fimbriae. Highlighting the importance of MR/P fimbriae is the cotranscribed regulator, MrpJ, which globally controls virulence. Overall, P. mirabilis exhibits an extraordinary lifestyle, and further probing will answer exciting basic microbiological and clinically relevant questions.

Pathogenesis of Proteus mirabilis Infection

“…Because fimbriae are often found to contribute to virulence, there are multiple studies examining the roles of P. mirabilis -encoded fimbriae to UTI (Table 6) (19, 20, 232). P. mirabilis obtained from healthy stool or diarrhea, urine, or blood can adhere to voided human uroepithelial cells regardless of the bacterial source (233), which is consistent with the conservation of fimbrial genes in this species (106).…”

“…We will summarize studies that have made a clear connection between specific genes, gene clusters, and operons and their role in pathogenesis. While there is an enormous literature on the fascinating phenotype of swarming motility, this has been extensively summarized elsewhere (3, 18–20). We will therefore address only those studies that relate to flagellum-mediated motility and virulence in the murine model.…”

Spontaneous Expulsion of Giant Bladder Stone: Case Report

“…Our patient was diagnosed with recurrent Proteus mirabilis infection. This urease-producing uropathogen commonly causes cystitis, acute pyelonephritis and urinary calculus [7,8]. Once in the bladder, P. mirabilis can form luminal clusters that are the site of bladder stone formation.…”

Contactless Ammonia Mapping for Concentric Colony Pattern of <i>Proteus mirabilis</i>

“…The bacteria form crystalline biofilms on the catheters surface, which is highly tolerant to antibiotics (Melo et al, 2016). It produces ammonia by the effect of urease, causing pH increase in urea and finally stone formation (Griffith, 1978;Mobley and Hausinger, 1989;Schaffera et al, 2016;Norsworthy and Pearson, 2017). On an agar plate the bacteria develop a ring-like pattern, suggesting that the colony chooses between two states-a fast expansion state and a slow growth state (Schwarcz et al, 2016).…”