PROTEUS BACTERIUM
By. Dominic Edward Z. Tomas
What is Proteus?
Proteus is a genus of Gram-negative Proteobacteria, family of
Enterobacteriaceae.
Proteus species do not usually ferment lactose, but have shown to be capable
lactose fermenters depending on the species in a triple sugar iron (TSI) test.
General characters: It is oxidase-negative, but catalase- and nitrase-positive.
Specific tests include positive urease and phenylalanine deaminase tests.
On the species level, indole is considered reliable, as it is positive for Proteus
vulgaris but negative for Proteus mirabilis.
Some species are motile.
It has a characteristic "swarming" pattern.
Proteus vulgaris
Scientific classification
Kingdom: Bacteria
Phylum: Proteobacteria
Class: Gamma Proteobacteria
Order: Enterobacteriales
Family: Enterobacteriaceae
Genus: Proteus
Species: P. vulgaris
Figure 1. Proteus vulgaris
Swarming motility is a rapid (2-10 μm/s.) and coordinated translocation of a
bacterial population across solid or semi-solid surfaces.
Figure 2. Proteus vulgaris
Non-lactose fermenters with slight swarming.
Figure 3. Proteus vulgaris
EMB agar plate inoculated with Proteus vulgaris (a gram-negative
coliform bacterium) showing growth of pink colonies indicating non-
lactose fermentation and some acid production.
First, the cells are highly motile and often swarm across the surface of agar plates
(Figure A). Swarming gives rise to a very thin film of bacteria on the agar surface,
but swarming periods are interspersed with periods when the cells stop and
undergo a cycle of growth and division so that the colony has a distinct zonation.
The other notable feature of both Proteus and Providentia is the ability to degrade
urea to ammonia, by production of the enzyme urease (Figure B). Bacteria isolated
from urine samples are inoculated onto a nutrient agar containing urea and the
indicator phenol red. After overnight incubation, the ammonia produced by Proteus
or Providentia raises the pH and changes the colour of the medium from yellow to
red.
Proteus mirabilis
Scientific classification
Kingdom: Bacteria
Phylum: Proteobacteria
Class: Gamma Proteobacteria
Order: Enterobacteriales
Family: Enterobacteriaceae
Genus: Proteus
Species: P. mirabilis
Figure 4. Proteus mirabilis
P. mirabilis on an XLD agar plate.
Proteus mirabilis
Bacteria of the species Proteus mirabilis are widely
distributed in soil and water in the natural
environment.
In humans, Proteus is found as part of the normal
flora of the gut. Its main pathological role is in
infections of the urinary tract, but it can also cause
wound infections and septicaemia.
About a quarter of the human population will have Pr.
mirabilis in their faeces. Infection is often by the
strains resident in the patient’s faeces.
Proteus mirabilis
Proteus can exist in two distinct morphological and physiological
forms, known as swimmer cells and swarmer cells.
In aqueous suspension Pr. mirabilis is found in the swimmer state,
small rod-like cells1 to 2 μm in length motile by 8 to 10 flagella.
On contact with a surface, Proteus has the ability to convert to the
swarmer state. The bacterial cells elongate dramatically to form
highly flagellated filaments 20 to 80 μm in length. These cells line
up in parallel to form rafts that are able to move rapidly over
surfaces en masse.
Physiologically, there is a significant increase in protein synthesis
and urease is produced in amounts 30 to 80 times higher than in the
swimmer state.
Figure 5. Proteus mirabilis
Electron micrograph of Proteus mirabilis swarmer cells moving across
a surface.
Clinical significance
P. vulgaris, P. mirabilis, and P. penneri—are opportunistic human
pathogens.
Proteus includes pathogens responsible for many human urinary tract
infections.
Proteus mirabilis causes of wound and urinary tract infections. Most strains
of Proteus mirabilis are sensitive to ampicillin and cephalosporins. Once
attached to urinary tract, infects the kidney more commonly than E. coli.
Proteus mirabilis are often found as free-living organisms in soil and water.
Proteus vulgaris is not sensitive to these antibiotics. However, this
organism is isolated less often in the laboratory and usually only targets
immunosuppressed individuals. Proteus vulgaris occurs naturally in the
intestines of humans and a wide variety of animals; also manure, soil and
polluted waters.
Proteus Infections
Nosocomial infections
Proteus mirabilis causes 90% of Proteus infections.
Proteus vulgaris and Proteus penneri are easily isolated from
individuals in long-term care facilities and hospitals and from
patients with underlying diseases or compromised immune systems.
Patients with recurrent infections, those with structural
abnormalities of the urinary tract, those who have had urethral
instrumentation, and those whose infections were acquired in the
hospital have an increased frequency of infection caused by Proteus
and other organisms (e.g. Klebsiella, Enterobacter, Pseudomonas,
enterococci, staphylococci)
Treatment – Proteus vulgaris
Known antibiotics that P. vulgaris is sensitive to:
Ciprofloxacin
Ceftazidime
Netilmicin
Sulbactam or Cefoperazo
Meropenem
Piperacil or Tazobactam
Unasyn
Antibiotics should be introduced in much higher doses than "normal"
when P. vulgaris has infected the sinus or respiratory tissues. I.E.
Ciprofloxacin should be introduced at a level of at least 2000 mg per
day orally in such a situation, rather than the "standard" 1000 mg per
day.
Treatment – Proteus mirabilis
P. mirabilis is generally susceptible to most
antibiotics apart from tetracycline, however
10%–20% of P. mirabilis strains are also
resistant to first generation cephalosporins
and ampicillins.
Micro-organism Tests
Indole negative and Casein test-negative
Nitrate reductase Starch test- negative
positive (no gas Hydrogen sufide
bubbles produced) test- positive
Methyl Red negative Citrate agar test-
and Voges- positive
Proskauer positive
Catalase positive
and
Figure 6. Appearace of Enteric Organisms on Triple Sugar Iron
Medium
A. Salmonella sp. D. Proteus mirabilis
B. Escherichia coli
C. Unknown
