mirabilis is also a common agent of Gram-negative bacteremia, particularly in patients with concurrent UTI in recent studies, this species was found in 5-20% of these cases and as high as a 50% mortality rate in geriatric patients ( 13- 16). mirabilis CAUTI occurs in elderly patients during long-term catheterization.
mirabilis CAUTI likely reflects differences in the population surveyed and the types of samples collected. This organism is more common in complicated urinary tract infections (such as patients with spinal cord injury or anatomical abnormality) and especially contributes to catheter-associated UTI (CAUTI), causing 10-44% of long-term CAUTIs at a cost of $43-256 million in the US annually ( 6, 11, 12). In 2006, UTIs in the United States were the cause of 11 million physician visits and cost $3.5 billion dollars ( 10). In the most recent large North American study, this species caused 4% of almost 3,000 UTI cases ( 9). mirabilis causes between 1-10% of all urinary tract infections, varying with the geographic location of the study, the types of samples collected, and the characteristics of the patients examined. It is thought that antibodies against hemolysin and urease enzymes are subsequently able to recognize self antigens targeted in rheumatoid arthritis patients ( 8). mirabilis to rheumatoid arthritis, although others have failed to find an association (reviewed in ( 7) and ( 8)). In addition to urinary tract infection, this species can also cause infection in the respiratory tract, eye, ear, nose, skin, throat, burns, and wounds and has been implicated in neonatal meningoencephalitis, empyema, and osteomyelitis ( 1, 6). mirabilis in their stool, while others have no P. This is supported by evidence that some patients with P. mirabilis urinary tract infections (UTI) result from ascension of bacteria from the gastrointestinal tract while others are due to person-to-person transmission, particularly in healthcare settings ( 1). mirabilis is often isolated from the gastrointestinal tract, although whether it is a commensal, a pathogen, or a transient organism, is somewhat controversial ( 4). mirabilis infections can cause the formation of urinary stones (urolithiasis). These infection s can also cause bacteremia and progress to potentially life-threatening urosepsis. mirabilis is capable of causing symptomatic infections of the urinary tract including cystitis and pyelonephritis and is present in cases of asymptomatic bacteriuria, particularly in the elderly and patients with type 2 diabetes ( 2, 3). While significant advances in this field have been made, challenges remain to combatting complicated UTI and deciphering P. mirabilis uses a diverse set of virulence factors to access and colonize the host urinary tract, including urease and stone formation, fimbriae and other adhesins, iron and zinc acquisition, proteases and toxins, biofilm formation, and regulation of pathogenesis. The regulation of this complex process and its contribution to virulence is discussed, along with the type VI-secretion system-dependent intra-strain competition which occurs during swarming. Flagella-mediated motility, both swimming and swarming, is a central facet of this organism. mirabilis with a focus on urinary tract infections (UTI), including disease models, vaccine development efforts, and clinical perspectives. Clinically, this organism is most frequently a pathogen of the urinary tract, particularly in patients undergoing long-term catheterization. Proteus mirabilis is a Gram-negative bacterium which is well-known for its ability to robustly swarm across surfaces in a striking bulls’-eye pattern.
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