Increased incidence of urolithiasis and bacteremia during Proteus mirabilis and Providencia stuartii coinfection due to synergistic induction of urease activity.

Background: Catheter-associated urinary tract infections (CaUTIs) are the most common hospital-acquired infections worldwide and are frequently polymicrobial. The urease-positive species Proteus mirabilis and Providencia stuartii are two of the leading causes of CaUTIs and commonly co-colonize cathe...

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Publicado en:Journal of Infectious Diseases Vol. 209; no. 10; pp. 1524 - 1533
Autores principales: Armbruster, Chelsie E, Smith, Sara N, Yep, Alejandra, Mobley, Harry L T
Formato: Journal Article
Publicado: Oxford University Press / USA May2014
Acceso en línea:Ver este registro en EBSCOhost
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        00221899
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      jtl: Journal of Infectious Diseases
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      dt: May2014
      vid: 209
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      pub: Oxford University Press / USA
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        10.1093/infdis/jit663
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        atl: Increased incidence of urolithiasis and bacteremia during Proteus mirabilis and Providencia stuartii coinfection due to synergistic induction of urease activity.
      aug:
        au:
          Armbruster, Chelsie E
          Smith, Sara N
          Yep, Alejandra
          Mobley, Harry L T
        affil: Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan.
      sug:
        subj:
          Bacteremia Microbiology
          Infection
          Enterobacteriaceae Infections Complications
          Proteus
          Enterobacteriaceae
          Urolithiasis Microbiology
          Animals
          Enterobacteriaceae Infections Microbiology
          Genes
          Genes Physiology
          Mice
          Proteus Infections Complications
          Proteus Infections Microbiology
          Urease Metabolism
      ab: Background: Catheter-associated urinary tract infections (CaUTIs) are the most common hospital-acquired infections worldwide and are frequently polymicrobial. The urease-positive species Proteus mirabilis and Providencia stuartii are two of the leading causes of CaUTIs and commonly co-colonize catheters. These species can also cause urolithiasis and bacteremia. However, the impact of coinfection on these complications has never been addressed experimentally.Methods: A mouse model of ascending UTI was utilized to determine the impact of coinfection on colonization, urolithiasis, and bacteremia. Mice were infected with P. mirabilis or a urease mutant, P. stuartii, or a combination of these organisms. In vitro experiments were conducted to assess growth dynamics and impact of co-culture on urease activity.Results: Coinfection resulted in a bacterial load similar to monospecies infection but with increased incidence of urolithiasis and bacteremia. These complications were urease-dependent as they were not observed during coinfection with a P. mirabilis urease mutant. Furthermore, total urease activity was increased during co-culture.Conclusions: We conclude that P. mirabilis and P. stuartii coinfection promotes urolithiasis and bacteremia in a urease-dependent manner, at least in part through synergistic induction of urease activity. These data provide a possible explanation for the high incidence of bacteremia resulting from polymicrobial CaUTI.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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