Proteus species are part of the Enterobacteriaceae family of gram-negative bacilli.

Organisms are a serious causes of infections in humans.

Proteus species are most commonly found in the human intestinal tract, along with Escherichia coli and Klebsiella species.

Found in long-term care facilities and hospitals.

In hospital settings its ability to colonize both the skin and oral mucosa of both patients and hospital personnel leads to infections.

Proteus mirabilis causes 90% of Proteus infections.

Proteus mirabilis infection is considered community-acquired.

Proteus vulgaris and Proteus penneri commonly isolated in long-term care facilities and hospitals.

Proteus infections common in patients with structural abnormalities of the urinary tract, those with urethral instrumentation, and acquired hospital infections.

Proteus species possess an extracytoplasmic outer membrane containing a lipid bilayer, lipoproteins, polysaccharides, and lipopolysaccharides.

The presence of fimbriae on Proteus mirabilis facilitates adherence to host tissues and increase risk of infection.

The attachment of Proteus species to uroepithelial cells initiates several events in the mucosal endothelial cells, including secretion of interleukin 6 and interleukin 8.

Organisms induce apoptosis and epithelial cell desquamation.

Urease production, together with the presence of bacterial motility and fimbriae, may favor the production of upper urinary tract infections.

Proteus organisms are gram-negative bacilli, they can cause gram-negative endotoxin-induced sepsis, and a systemic inflammatory response syndrome with a mortality rate of 20%-50%.

Produces urease and alkalinizes the urine by hydrolyzing urea to ammonia and therefore makes it effective in producing an environment promoting survival of these organisms.

Urease production and alkalinization of the urine leads to precipitation of organic and inorganic compounds, which leads to struvite stones which are composed of a combination of magnesium ammonium phosphate (struvite) and calcium carbonate-apatite.

UTIs are the most common clinical manifestation of Proteus infections, and accounts for 1%-2% of UTIs in healthy women and 5% of hospital-acquired UTIs.

Complicated UTIs, those associated with urinart tract catheterization, have a prevalence of 20%-45%.

In the neonatal population UTIs are more common in males then females as a result of congenital abnormalities seen more often in males.

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