How many species of proteus

Renew my subscription. Tags Type your tag names separated by a space and hit enter. Proteus species Paul Auwaerter, M. Citation Auwaerter, Paul.

Johns Hopkins Guide , www. Auwaerter P. Proteus species. The Johns Hopkins University; Accessed November 12, Auwaerter, P. The Johns Hopkins University. Proteus Species [Internet]. A striking microbiologic characteristic of Proteus species is their swarming activity.

Swarming appears macroscopically as concentric rings of growth emanating from a single colony or inoculum. On a cellular level, swarming results from bacterial transformation from "swimmer cells" in broth to "swarmer cells" on a surface such as agar, in a process involving cellular elongation and increased flagellin synthesis The genus name Proteus originates from the mythological Greek sea god Proteus , who was an attendant to Poseidon Proteus could change his shape at will.

This attribute reminded early microbiologists of the morphologic variability of the Protei on subculture, including their ability to swarm. Members of the genus Proteus are widespread in the environment and are found in the human gastrointestinal tract 9. The most common infections caused by Proteus spp. Proteus spp. Therefore, like Escherichia coli , Proteus spp. It is a common cause of bacteremia following catheter-associated UTI 90 , and in rare cases has been reported to cause cellulitis, endocarditits, mastoiditis, empyema, and osteomyelitis 24 , 61 , 86 , It has also been suggested that P.

There has also been one case study of P. There has been one case study of P. There has also been one recent report of P. Notably, P. Thus, the burden of human infections caused by this organism may be underestimated. The clinical manifestations of infections with Proteus spp.

However, urinary tract infections involving struvite stones are characteristic. By producing urease, Proteus spp. Alkalinization of urine promotes precipitation of magnesium-ammonium phosphate salts leading to the formation of struvite stones, which may serve as a nidus for the persistence of infection or may directly obstruct the urinary tract, thereby promoting infection.

The members of the genus Proteus are Gram negative, motile facultative anaerobic rods. On culture plates, Proteus species are distinguished by their ability to swarm. The Proteus genomospecies 4, 5, and 6 can be distinguished from other Proteus species based on five biochemical characteristics: esculin hydrolysis, salicin fermentation, L-rhamnose fermentation, and elaboration of DNase and lipase.

They have pili or fimbriae for adherence to uroepithelium. Additionally, they elaborate cytotoxic hemolysins that lyse red cells and release iron, a bacterial growth factor. Proteus isolates possess flagella for motility. As noted above they produce urease, leading to the formation of struvite stones. In the last decade there have also been numerous reports of production of extended-spectrum beta-lactamases ESBLs by Proteus spp..

The ESBLs can confer resistance to third generation cephalosporins such as cefotaxime, ceftriaxone and ceftazidime, as well as the monobactam, aztreonam The cephamycins cefoxitin, cefotetan and cefmetazole and the carbapenems imipenem and meropenem are generally not hydrolyzed by ESBLs However, resistance to carbapenems is starting to be observed in Proteus spp.

It should be noted that the MICs for third generation cephalosporins or aztreonam may not reach widely used breakpoints for resistance with some ESBL producing Proteus isolates. In , there was a change in the CLSI recommendations for susceptibility breakpoints, resulting in many ESBL-producing isolates previously considered to be resistant to these antibiotics now being regarded as susceptible 39 , 93 , Due to these changes in breakpoints for susceptibility, data concerning resistance to celphalosporins, aztreonam, and carbapenems may be underestimated.

Proteus mirabilis : Overall, the majority of P. The new glycylcycline, tigecycline , also has surprisingly poor in vitro activity, compared to its activity against other Gram negative bacilli High levels of ciprofloxacin resistance have been reported in Poland 94 , though norfloxacin remained effective against these isolates 94 , and qnr quinolone resistance genes have been identified in P. A compendium of antibiotic resistance of P. CTX-M has been found on the P. Metallo-beta-lactamases MBLs are also being reported in recent P.

For instance, one study from France identified a P. Interestingly, NDM-1 was present in a genomic island in one isolate of P. Multidrug resistance in P. SGI-1 confers resistance to a wide variety of older drugs that are no longer commonly used to treat human infection, but the multidrug-resistant regions of SGI-1 from P.

Interestingly, ESBL production was found to be a risk factor for ciprofloxacin-resistant bacteremia due to P. A recent study from Tunisia also identified a high prevalence of plasmid-mediated quinolone resistance determinants among ESBL-producing P.

These beta-lactamases are not inhibited by clavulanic acid, sulbactam and tazobactam. It should be noted that these beta-lactamases do not have extended-spectrum activity that is, they do not hydrolyze third generation cephalosporins. Another mechanism of beta-lactamase inhibitor resistance in P. AmpC type beta-lactamases also termed group 1 or class C beta-lactamases can either be chromosomally encoded or plasmid encoded in P.

AmpC has also been found on the chromosome as part of integrative and conjugative elements ICE Strains with plasmid-mediated AmpC beta-lactamases are consistently resistant to aminopenicillins ampicillin or amoxicillin , carboxypenicillins carbenicillin or ticarcillin and ureidopenicillins piperacillin. MICs for aztreonam are usually in the resistant range but may occasionally be in the susceptible range.

AmpC beta-lactamases generally do not effectively hydrolyze cefepime or the carbapenems. Carbapenems are generally active against P. However, imipenem MICs are frequently higher for P. Meropenem is more potent than imipenem against P. Proteus vulgaris : Proteus vulgaris produces a chromosomally encoded beta-lactamase 23 , referred to as the cefuroxime-hydrolyzing beta-lactamase cefuroximase or CumA 34 , which hydrolyzes cephalosporins. The enzyme can be induced by ampicillin, amoxicillin and first generation cephalosporins, weakly induced by carboxypenicillins, ureidopenicillins, cefotaxime and ceftriaxone, and inhibited by clavulanate.

Strains of P. Ertapenem and meropenem are substantially more active than imipenem It has been noted that the MICs of several oxyimino type expanded-spectrum cephalosporins, such as cefotaxime and cefpodoxime, are much higher when broth microdilution methods are used than when agar dilution methods are used in vitro susceptibility testing of P.

Proposed mechanisms for this MIC gap phenomenon are unclear Quinolones and aminoglycosides are usually active against P. Very few in vivo animal models of Proteus infections have been established in which antimicrobial activities were assessed. Treatment of Proteus sepsis in rats with ceftazidime or carbapenems was associated with an increase in the plasma endotoxin concentration However, the antibiotic concentrations in those animals treated with carbapenems were significantly lower than for animals treated with ceftazidime.

The significance of this finding is uncertain. Urinary tract infection is the most common clinical manifestation of Proteus infections. Empiric treatment for community-acquired urinary tract infection will depend more on susceptibilities of E. For hospitalized patients or those with urinary catheters, the first decision is whether the isolate is clinically significant.

Isolates which are not accompanied by pyuria or symptoms do not warrant treatment. Based on the compiled antibiotic resistance data provided in Table 1 , trimethoprim or cotrimoxazole may no longer be viable treatment options for P.

Quinolone resistance is also increasing, and P. The most appropriate treatment for P. Recent P. In general, treatment should be with intravenous agents or oral therapy for quinolones until fever has resolved. Correction of the underlying anatomical abnormality or removal of a urinary catheter is also frequently necessary. The treatment of choice of P. Carbapenems are the treatment of choice for ESBL producing isolates causing bacteremia The basis for this statement is not just the almost uniform in vitro susceptibility but also increasingly extensive clinical experience.

However it must be pointed out that this experience is in organisms such as K. Quinolones are probably a reasonable option if the isolate is susceptible. In view of the presence of an inducible beta-lactamase in P. The development of resistance to ceftriaxone , occurring during treatment, has been seen with P. Treatment recommendations are the same for this organism as for P. Proteus meningitis usually follows neurosurgical procedures Third generation cephalosporins are indicated in the treatment of P.

Aztreonam has also been successfully used in the treatment of Proteus meningitis, and may be an option in penicillin allergic patients Removal of neurosurgical hardware should be considered wherever possible. Infective endocarditis due to P. The few cases that have been reported appear to have been related to prosthetic valves 8 , Therefore early surgical intervention is likely the key to successful outcome.

Therapeutic options would appear to be an appropriate beta-lactam see section on therapy of bacteremia above plus an aminoglycoside. Serious infections in patients with life-threatening allergies to beta-lactam antibiotics could comprise aminoglycosides or possibly either quinolones or cotrimoxazole. Nitrofurantoin is not an option nor is tetracycline or the glycylcycline class. As noted above, early surgical consultation is necessary in patients with Proteus endocarditis or post-neurosurgical meningitis.

Urologic consultation should be sought in patients with recurrent Proteus urinary tract infection, especially in the presence of struvite stones Generally, standard clinical endpoints are used for determining the adequacy of therapy for Proteus infections. After initiation of therapy, a favorable response is signified by resolution of systemic and local symptoms and signs of infection. In patients with primary or secondary bacteremia, blood cultures should become negative.

For urinary tract infections, urine cultures should become negative. In patients with Proteus meningitis, a repeat spinal tap after 48 to 72 hours may be helpful to document microbiologic clearance.

The duration of therapy after an initial favorable clinical response is generally empiric. Pneumonia, bacteremia and urinary tract infections require at least 10 days of therapy. Meningitis should be treated for 21 days, and endocarditis for at least 42 days.

If fever recurs during therapy, then a superinfection or a drug allergy should be considered. Many of the patients infected with P. No vaccines are commercially available at the present time. However, P.

Typing methods for P. The ability of P. Also, in Nigeria, Proteus spp. Also, in soil, the presence of Proteus spp. Srinivasan et al. Thus, it was suggested that the bacteria associated with fecal contamination of soil may have come from other animals, because the soil samples also contained Toxocara spp.

In fact, these proteolytic microorganisms come to these environments with feces or waste, and after digestion of approachable organic matter, they decay due to the lack of nutrients.

However, these microorganisms are also found in such habitats as autochthones, well adapted to the environmental conditions, exhibiting unusual and exceptional metabolic features Table 4 , although this aspect of the genus Proteus lifestyle is less known. An interesting example is a P.

The processes and the cell growth were inhibited in the absence of any organic source of carbon. Similar metabolic activity was displayed by the Proteus sp. Simultaneous aerobic nitrification and denitrification leading to the efficient removal of nitrogen by this heterotrophic bacterium are suggested to be applied in fish waste treatment.

They may play a role of effective and specialized plant-growth-promoting rhizobacteria PGRP or bioremediators of hydrocarbons, pesticides, herbicides, aromatic compounds, azo dyes, and heavy metals in contaminated environments.

Lipase production is not typical of all Proteus species Table 1 , but the rods in natural environments are able to effectively degrade hydrocarbons, including oils, and to remove these hazardous substances efficiently and inexpensively. Kim et al. The lipase was stable from pH 5 to 11 and had a maximum activity at pH The first report on a Proteus sp. The strain may be presumed to belong to P. It was found in tropical soil containing total petroleum hydrocarbons TPHs in the Tabasco region, Mexico, highly contaminated by oil spills during 20 years of pollution and was able to remove the superficial hydrocarbon layer the only carbon source in the culture medium forming a stable emulsion, most probably due to the production of biosurfactants by the strain itself.

The results were better than in the medium containing urea actively utilized by the bacteria; see Table 1. Then, Ibrahim et al.

Earlier, another hydrocarbon degrading P. The isolated strain was able to utilize Bonny light crude oil, diesel, and kerosene, generating organic acids. The finding is promising for this region, where the oil spills are a source of significant air, soil, and water pollution, destroying biodiversity in the ecosystem [ ].

Lutz et al. There are several reports on Proteus spp. The genus Proteus dominated after E. The genes responsible for the hydrocarbon degradation ability were located either chromosomally or extra-chromosomally. The plasmid location is promising for bioremediation processes since the genes can be conjugated to other microorganisms in polluted environments.

Ceyhan [ 22 ] reported on a P. Moreover, the degradation of this highly toxic and carcinogenic hydrocarbon resulted in non-toxic and non-accumulating metabolites, proving a big biodegradation potential of the strain. Gasoline-contaminated soil from a gas station in Chihuahua, Mexico, was the habitat of a P. Next, a P. Sanuth et al. The strain seems to be a potential candidate for its bioremediation. Bacteria from the genus Proteus solely or in consortia also display an ability to neutralize different toxic herbicides and pesticides that may cause heavy pollution in terrestrial and aquatic ecosystems, especially when inappropriately used.

Although DDD is also a toxic pesticide, its production is the first step during the degradation and mineralization of DDT, and it is utilized in further transformations. Correa and Steen [ 27 ] found a P. It is worth mentioning that Proteus spp. Another example of autochthonous Proteus sp. The strain exhibited also siderophore production, phosphate solubilizing capacities, and strong antifungal effect on phytopathogen Fusarium oxysporum , thus indicating the potential possibilities of its exploitation as PGPR as well.

From soil samples exposed to different kinds of waste including hazardous ones , a microbial consortium was isolated composed of ten strains, including P. The consortium was able to degrade two widely used organophosphatic pesticides, chlorpyrifos and methyl parathion, both in culture medium and in soil. A similar bacterial consortium was found in highly contaminated soil samples from Moravia, Medellin, an area that was used as a garbage dump from to [ ].

The consortium was able to degrade methyl parathion and p-nitrophenol as the only source of carbon and to decrease their toxicity in the medium and in soil at different depths. Azo dyes frequently used for textile dyeing and paper printing and their metabolites present in effluents may be toxic, mutagenic, or carcinogenic.

Their physicochemical neutralization is costly, while biological degradation is cost-effective and friendly to the environment, but difficult. For that reason, identification of the effective Proteus spp.

Patil et al. Chen et al. Furthermore, Olukanni et al. However, its laccase the azo-dye-degrading oxidoreductase activity was fold lower than that of another very effective strain, P. It effectively decolorized several mono- and di-azo dyes [ 23 , 24 ] and was copper-tolerant as its laccase was a copper-induced enzyme with thermophilic and acidophilic properties [ ]. However, the presence of copper in the environment reduced the swarming activity of the bacterium [ 96 ].

The isolate is the first reported non-pathogenic strain in the species P. There are more reports on the high tolerance of Proteus spp. Ge et al. Hassen et al. Also, a highly resistant to several heavy metals including mercury, copper, zinc, cadmium, cobalt, silver, and others P. Another strongly copper resistant strain identified as P.

The strain used to inoculate pigeon pea Cajanus cajan seeds protected the pea against the inhibitory effect of copper, reducing its amounts both in soil and in the plant. Moreover, the bacterium was able to produce siderophores providing pigeon pea with iron and preventing chlorosis. There are more examples of soil Proteus spp. Islam et al. The strain was able to block zinc absorption by maize Zea mays roots, reduce oxidative stress in the plant, and increase its tolerance to zinc, promoting maize growth in the presence of the heavy metal.

Simultaneously, the bacterium enhanced phytoremediation processes conducted by this copper-resistant plant. Rau et al. The strain displayed strong resistance to arsenic and was medium resistant to copper, chromium, cobalt, cadmium, zinc, mercury, nickel, and lead. Additionally, the strain produced siderophores with great capacity and was an active phosphate solubilizer, thus enhancing the growth of grass.

Similarly, a Proteus sp. Yet, rhizobacterial P. The strains successfully protected three tested species of leguminous plants from the pathogenic fungus Fusarium moniliformae ; when the seeds were bacterized during the sowing, they were able to colonize roots and promote the growth of host plants. Yu and Lee [ ] stated that indole production by the P. These promising results open wider possibilities of using specialized Proteus spp.

Bacteria from the genus Proteus are well known as human opportunistic pathogens and intestinal microorganisms indicating fecal pollution of water or soil.

Their presence in drinking water poses a threat of infection. On the other hand, the bacilli are believed to play an important role in removing organic pollutants of animal origin, especially fecal ones, by decomposing the dead organic matter in water or soil environments.

Their proteolytic and ureolytic properties may place the bacteria among the most efficient saprobes taking part in the enrichment of manured soils in ammonia salts and therefore participating in the nitrogen cycle.

However, the significance of these microorganisms in the mineralization processes of nitrogen-containing organic compounds is not obvious. This aspect of their metabolism requires more research. It would be reasonable to establish their exact contribution as destruents to the circulation of matter in nature. Their antagonistic or commensal relationships with numerous animals have also been documented. However, environments other than the human body are less recognized as habitats of Proteus spp.

In the future, more attention should be paid to the interdependences between Proteus spp. Relatively little information is available also about the mutual relations between Proteus spp. Establishing what kind of relationships these are and which organisms benefit from this system is the basis for determining the reasons why the bacilli occur in a given ecosystem and the consequences of their activity.

Nowadays, molecular techniques provide proper tools to investigate the microorganisms in their natural habitats. The differences in the biochemical features do not exclude the strain from a genus as long as the similarities on the genome level are big enough. It is important to employ molecular techniques in the identification of Proteus spp. Metagenomic analysis of soil and water environments as well as of different niches in human, animal, and plant organisms using proper primer sequences may reveal the presence of Proteus spp.

Numerous examples suggest that the application of these microorganisms may be an effective way of protecting plants and groundwater. The biological treatment of polluted natural environments is more efficient and cost-effective than physicochemical methods and can be used in large areas due to simple application and an ability to remove pollution completely.

Bioremediation could involve not only the stimulation of the natural autochthonic Proteus spp. However, it is important to remember that the bacteria belonging to the genus Proteus are opportunistic human and animal pathogens.

It would be useful and interesting to compare the features especially virulence factors, serotypes, metabolic apparatus, and the antibiotic resistance expressed by Proteus spp.

Do environmental Proteus spp. Do they possess genes coding the factors of pathogenicity identified in the strains isolated from patients? If so, do they express these factors and how do they use them in non-pathogenic conditions? What is the risk of transformation of a strain which could be used in bioremediation and environmental protection into a virulent one posing a threat to the animals or humans inhabiting the area?

Do the environmental strains carry antibiotic resistance genes, which might lead to the transfer of these genes into other microorganisms in the environment? Answers to these questions could explain which factors contribute to and in what way they are important in different lifestyles presented by Proteus spp.

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