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

Proteus mirabilis is a model organism for urease+ organisms that are associated with CAUTIs and infectious stones. P. mirabilis forms extensive crystalline biofilms on catheters that are infamously difficult to treat. Once in the bladder, P. mirabilis can form luminal clusters that are the site of bladder stone formation. At least two virulence factors, urease and MR/P fimbriae, are required for both cluster formation and crystalline biofilm formation on catheters. The MR/P regulator, MrpJ, controls a variety of other known and putative virulence factors. Polymicrobial infections can lead to synergistic enhancement of UTI and may have clinically relevant consequences. 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 polymicrobial 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. 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 polymicrobial 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. a common urinary stone mineral with the chemical formula: [Ca10(PO4)6CO3] [6Bichler K.H. et al.Urinary infection stones.Int. J. Antimicrob. Agents. 2002; 19: 488-498Abstract Full Text Full Text PDF PubMed Scopus (205) Google Scholar]. catheter-associated urinary tract infection. A UTI that occurs when a urinary catheter is indwelling for >2 days and symptoms appear during catheterization or a day before removalii. a method for growing bacterial biofilms utilizing a flow chamber with continuously cycling fresh or spent media [91Tolker-Nielsen T. Sternberg C. Growing and analyzing biofilms in flow chambers.Curr. Protoc. Microbiol. 2011; (Chapter 1, Unit 1B 2)Crossref PubMed Scopus (56) Google Scholar]. an in vitro assay that assesses whether factors such as bacteria, viruses, or antibodies can agglutinate red blood cells. a common infection stone mineral with the composition: [(NH4)(MgPO4·6H2O)] [6Bichler K.H. et al.Urinary infection stones.Int. J. Antimicrob. Agents. 2002; 19: 488-498Abstract Full Text Full Text PDF PubMed Scopus (205) Google Scholar]. a possibly life-threatening systemic inflammatory response (sepsis) to a urogenital infection [92Wagenlehner F.M. et al.Diagnosis and management for urosepsis.Int. J. Urol. 2013; 20: 963-970PubMed Google Scholar]. epithelial cells that line the inner surface of the renal pelvis, ureters, bladder, and urethra [93Wu X.R. et al.Uroplakins in urothelial biology, function, and disease.Kidney Int. 2009; 75: 1153-1165Abstract Full Text Full Text PDF PubMed Scopus (254) Google Scholar].