Proteus penneri and urinary calculi formation

Abstract

The clinical significance of Proteus penneri, a newly described species, is unknown. A case report is presented, which is to the best of our knowledge the first description of this organism causing a urinary tract infection and bladder calculi. Recent revisions in the classification of the Proteeae, a tribe of bacteria belonging to the family Enterobacteriaceae, recognized three genera, namely, Proteus, Providencia, and Morganella (3). In the genus Proteus, three species were identified. These included the well-known P. vulgaris and P. mirabilis species. A third, P. myxofaciens, was proposed for an organism isolated from gypsy moth larvae (Porthetria dispar), but is not of clinical importance. Bacteria formerly in the genus Proteus and previously classified as Proteus rettgeri and Proteus morganii were reassigned to the genera Providencia and Morganella, respectively. Subsequent studies of 20 indole-negative strains generally grouped with P. vulgaris led to the finding that they constituted a separate species (8). The name given to this species was Proteus penneri (10). Although strains of this species have been reported to be isolated from urine, stool, and blood specimens, their clinical significance is largely unknown (8). With the report of this new species, more attention was given to the precise classification of the Proteus species in our laboratory. This species may be differentiated by tests for esculin hydrolysis, salicin, and indole (all negative at 48 h) which are readily performed in clinical laboratories. This

Classification, Identification, and Clinical Significance ofProteus,Providencia, andMorganella

“…P. penneri has been implicated in a case of bacteremia and concomitant subcutaneous thigh abscess in a neutropenic patient with acute lymphocytic leukemia (23) and in nosocomial urosepsis in a diabetic patient from whom the organism was also subsequently isolated from bronchoalveolar lavage fluid and a pulmonary artery catheter tip (60). The urease enzyme of P. penneri is also believed to be a leading cause of kidney stone formation (40); indeed, the organism has been isolated from the center of a stone removed from a patient with persistent P. penneri bacteriuria (57). P. penneri has also been isolated from stool and infected conjunctiva.…”

Microbial ureases: significance, regulation, and molecular characterization.

“…group D2 (213); and Usreaiplasnma iorealyticllnm (84). Recently, the first description of urinary calculi by Protelis penneri, a newly classified species, was reported by Krajden et al (118). In addition, Pro'idencia stiuar-tii, Klebsiella pnieilnoniae, Pr-oteius X'u/garis, and Morganell// inorgainii are often associated with spinal injury patients whose kidney stones are related to persistent polymicrobial bacteriuria caused by long-term catheterization (194,241,242).…”

Proteinases of Proteus spp.: purification, properties, and detection in urine of infected patients

“…Proteus mirabilis is a common cause of urinary tract infection, particularly in young boys (3,9,12) and the elderly (26) and is, after Escherichia coli, the organism most frequently associated with urinary tract infections. Strains of Proteus vulgaris and P. penneri can also cause urinary tract infection (15) but are less frequently implicated, probably because of their lower carriage rate in feces (26,32).…”