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Infection and immunity v.85 no.2, 2017년, pp.e00808-16 - e00808-16   SCI SCIE
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The Pathogenic Potential of Proteus mirabilis Is Enhanced by Other Uropathogens during Polymicrobial Urinary Tract Infection

Armbruster, Chelsie E. (Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ; Smith, Sara N. (Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ; Johnson, Alexandra O. (Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ; DeOrnellas, Valerie (Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ; Eaton, Kathryn A. (Laboratory Animal Medicine Unit, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ; Yep, Alejandra (Biological Sciences Department, California Polytechnic State University, San Luis Obispo, California, USA ) ; Mody, Lona (Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ; Wu, Weisheng (Department of Computational Medicine & Bioinformatics, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ; Mobley, Harry L. T. (Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA ) ;
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    Urinary catheter use is prevalent in health care settings, and polymicrobial colonization by urease-positive organisms, such as Proteus mirabilis and Providencia stuartii , commonly occurs with long-term catheterization. We previously demonstrated that coinfection with P. mirabilis and P. stuartii increased overall urease activity in vitro and disease severity in a model of urinary tract infection (UTI). In this study, we expanded these findings to a murine model of catheter-associated UTI (CAUTI), delineated the contribution of enhanced urease activity to coinfection pathogenesis, and screened for enhanced urease activity with other common CAUTI pathogens. In the UTI model, mice coinfected with the two species exhibited higher urine pH values, urolithiasis, bacteremia, and more pronounced tissue damage and inflammation compared to the findings for mice infected with a single species, despite having a similar bacterial burden within the urinary tract. The presence of P. stuartii , regardless of urease production by this organism, was sufficient to enhance P. mirabilis urease activity and increase disease severity, and enhanced urease activity was the predominant factor driving tissue damage and the dissemination of both organisms to the bloodstream during coinfection. These findings were largely recapitulated in the CAUTI model. Other uropathogens also enhanced P. mirabilis urease activity in vitro , including recent clinical isolates of Escherichia coli , Enterococcus faecalis , Klebsiella pneumoniae , and Pseudomonas aeruginosa . We therefore conclude that the underlying mechanism of enhanced urease activity may represent a widespread target for limiting the detrimental consequences of polymicrobial catheter colonization, particularly by P. mirabilis and other urease-positive bacteria.


  • 주제어

    CAUTI .   Enterococcus .   Proteus mirabilis .   Providencia stuartii .   UTI .   catheter-associated urinary tract infection .   polymicrobial .   urease .   urinary tract infection.  

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