Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China,
Urol Int. 2021;105(5-6):354-361. doi: 10.1159/000514097. Epub 2021 Mar 10.
Proteus mirabilis (PM) is a Gram-negative rod-shaped bacterium and widely exists in the natural environment, and it is most noted for its swarming motility and urease activity. PM is the main pathogen causing complicated urinary tract infections (UTIs), especially catheter-associated urinary tract infections. Clinically, PM can form a crystalline biofilm on the outer surface and inner cavity of the urethral indwelling catheter owing to its ureolytic biomineralization. This leads to catheter encrustation and blockage and, in most cases, is accompanied by urine retention and ascending UTI, causing cystitis, pyelonephritis, and the development of bladder or kidney stones, or even fatal complications such as septicemia and endotoxic shock. In this review, we discuss how PM is mediated by a catheter into the urethra, bladder, and then rose to the kidney causing UTI and the main virulence factors associated with different stages of infection, including flagella, pili or adhesins, urease, hemolysin, metal intake, and immune escape, encompassing both historical perspectives and current advances.
奇异变形杆菌（PM）是一种革兰氏阴性杆状细菌，广泛存在于自然环境中，其最显著的特征是 swarm 运动和 urease 活性。PM 是引起复杂尿路感染（UTI）的主要病原体，尤其是与导尿管相关的尿路感染。临床上，由于 ureolytic biomineralization，PM 可以在尿道留置导管的外表面和内腔形成结晶生物膜。这会导致导管结垢和堵塞，在大多数情况下，伴有尿潴留和上行性 UTI，引起膀胱炎、肾盂肾炎和膀胱或肾结石的发展，甚至致命的并发症，如败血症和内毒素休克。在这篇综述中，我们讨论了 PM 如何通过导管进入尿道、膀胱，然后上升到肾脏引起 UTI，以及与感染的不同阶段相关的主要毒力因子，包括鞭毛、菌毛或黏附素、urease、溶血素、金属摄入和免疫逃避，涵盖了历史观点和当前进展。
