Proteus mirabilis biofilms and catheter-associated urinary tract infections.

Proteus mirabilis inhabits the environment and causes a number of infections including those of the skin, respiratory tract, wounds and urinary tract. These organisms express virulence factors associated with adhesion, motility, immunoavoidance, nutrient acquisition, host damage, as well as biofilm formation. P. mirabilis produces biofilms in diverse habitats with those formed in the human host playing a key role in indwelling device infections. The most studied P. mirabilis biofilms are those formed when the organism is grown in urine, resulting in unique features including the presence of swarmer cells and struvite and hydroxyapatite crystals upon growth in urine. Factors relevant to P. mirabilis biofilm formation include adhesion factors, proteins involved in LPS production, transporters, transcription factors, two component systems, communication factors and enzymes. P. mirabilis biofilm research will lead to a better understanding of the disease process and will subsequently lead to the development of new prevention, and treatment options.