AUTHOR=Chakkour Mohamed , Hammoud Zeinab , Farhat Solay , El Roz Ali , Ezzeddine Zeinab , Ghssein Ghassan 

TITLE=Overview of Proteus mirabilis pathogenicity and virulence. Insights into the role of metals

JOURNAL=Frontiers in Microbiology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2024.1383618

DOI=10.3389/fmicb.2024.1383618

ISSN=1664-302X

ABSTRACT=<p><italic>Proteus mirabilis</italic> is a Gram-negative bacterium with exclusive molecular and biological features. It is a versatile pathogen acclaimed for its distinct urease production, swarming behavior, and rapid multicellular activity. Clinically, <italic>P. mirabilis</italic> is a frequent pathogen of the human urinary system where it causes urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs). This review explores the epidemiology, risk factors, clinical manifestations, and treatment of <italic>P. mirabilis</italic> infections, emphasizing its association with UTIs. The bacterium’s genome analysis revealed the presence of resistance genes against commonly used antibiotics, an antibiotic-resistant phenotype that poses a serious clinical challenge. Particularly, the emergence of extended-spectrum β-lactamases (ESBLs) and carbapenemases resistant <italic>P. mirabilis</italic> strains. On a molecular level, <italic>P. mirabilis</italic> possesses a wide array of virulence factors including the production of fimbriae, urease, hemolysins, metallophores, and biofilm formation. This review thoroughly tackles a substantial gap in understanding the role of metallophores in shaping the virulence factors of <italic>P. mirabilis</italic> virulence. Siderophores, iron metal chelating and transporting metallophores, particularly contribute to the complex pathogenic strategies, displaying a potential target for therapeutic intervention.</p>