782 Potent urease production contributes to colonization, stone formation, and obstruction, 786,796–798 without which the infectivity of Proteus is diminished. 795 Ascending UTIs are common, and fimbriae and adhesins are necessary, but not sufficient, to produce infection. 793,794 which have been shown to contribute to bladder colonization in a murine model.

782, 791 These microorganisms have multiple features devoted to adherence and motility 792 and may produce several types of pili, the most important of which are mannose-resistant Proteus-like (MR/P) fimbriae. mirabilis has received considerable attention. Infections not related to the urinary tract or bloodstream have been reported with much less frequency. 790 Proteus has a remarkable ability to persist in the urinary tract despite antibiotics and catheter exchange, likely due to immune evasion and the protective reservoir that urinary stones provide. 639,787–789 Community-acquired Proteus UTIs in the presence of hydronephrosis or urolithiasis have increased risk of bacteremia. 785, 786 Proteus are common among the gram-negative bloodstream isolates, with most secondary to UTI and often associated with urinary catheters. are common causes of UTIs, occasionally in normal hosts 784 but more often in those with indwelling catheters or anatomic or functional urinary tract abnormalities. 783 Morganella morganii is, at present, the only member of its genus and is citrate negative. These bacteria can be differentiated from Proteus and Morganella based on their ability to use citrate and ferment d-mannitol. Providencia stuartii is the most common species of its genus isolated from clinical specimens, but Providencia rettgeri is occasionally grown. 782 The name Proteus follows from the character in Homer's Odyssey who is capable of changing form.

This swarming motility is regulated through a complex network acting on the flagellar transcription regulator, flhDC. 218.8) from sequential rounds of swarm cell differentiation and can overwhelm accompanying organisms. This motility produces a characteristic pattern on growth plates ( Fig. In contrast to most Enterobacteriaceae, these bacteria may express large numbers of fimbriae and flagella, transforming them into highly elongated rods that translocate rapidly across the surface of agar plates, resulting in a characteristic “swarming” motility. Both produce urease and hydrogen sulfide, and the latter is indole positive. Proteus mirabilis and Proteus vulgaris account for most clinical Proteus isolates. The genera Proteus, Providencia, and Morganella are related members of the Enterobacteriaceae that are lactose negative and motile and produce phenylalanine deaminase. Bennett MD, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 2020 Proteus, Providencia, and Morganella

What is proteus