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Introduction

Proteus penneri is a Gram-negative bacterium primarily found in soil and water. It belongs to the family Enterobacteriaceae, closely related to Proteus mirabilis. However, it differs from P. mirabilis in its biochemical behavior and antibiotic resistance. Additionally, P. penneri frequently causes infections in humans, especially urinary tract infections. This bacterium is less common than P. mirabilis, yet its clinical significance is growing. Importantly, it has shown resistance to certain antibiotics, making treatment challenging. Moreover, P. penneri can form biofilms, which further complicates medical treatment. This biofilm formation often leads to increased persistence in infections. While it primarily affects immunocompromised patients, it can also infect otherwise healthy individuals. Therefore, healthcare providers should be aware of its potential role in healthcare-associated infections. Ongoing research continues to explore more effective treatment options for infections caused by P. penneri.

Morphology

Proteus penneri exhibits a rod-shaped, Gram-negative structure typical of the Enterobacteriaceae family. The cells appear as short rods under a microscope, often arranged singly or in pairs. Like other Proteus species, P. penneri is motile, thanks to its peritrichous flagella, which aid in movement. However, it does not swarm as aggressively as Proteus mirabilis on agar plates. Additionally, its colony morphology is distinctive, forming smooth or slightly irregular colonies on culture media. In some cases, it produces a fishy odor, especially during prolonged growth on agar. Importantly, P. penneri is non-spore-forming and facultatively anaerobic, thriving in both aerobic and anaerobic environments. Moreover, this bacterium is able to grow at a wide range of temperatures, typically between 25°C and 37°C. Due to its biofilm-forming capability, it often displays enhanced resistance to antibiotics. Therefore, understanding its morphology helps in identifying this pathogen in clinical settings.

Pathogenicity

Proteus penneri is an opportunistic pathogen that primarily causes urinary tract infections (UTIs). It often infects immunocompromised individuals, particularly those with underlying health conditions. Additionally, P. penneri can cause wound infections, especially in hospital environments. This bacterium has the ability to form biofilms, which significantly increases its virulence and persistence in infections. Because of this biofilm formation, it becomes more resistant to antibiotics, making treatment difficult. Moreover, P. penneri produces urease, an enzyme that hydrolyzes urea, increasing urine pH and promoting kidney stone formation. This pathogenic trait is common in Proteus species and contributes to their ability to cause chronic UTIs. Occasionally, it can also cause sepsis, especially in vulnerable patients. Furthermore, its multidrug resistance adds to the challenges of managing infections. Therefore, P. penneri requires careful monitoring in healthcare settings to prevent serious complications and treatment failures.

Lab Diagnosis

The diagnosis of Proteus penneri begins with specimen collection from infected sites, often urine or wound swabs. The specimens are cultured on selective media like MacConkey or blood agar. On these plates, P. penneri forms smooth, non-swarming colonies, unlike P. mirabilis. Furthermore, it can produce a fishy odor, aiding in preliminary identification. Biochemical tests, such as urease and indole tests, help differentiate P. penneri from other Proteus species. Unlike P. mirabilis, P. penneri is indole-negative but urease-positive. Additionally, it exhibits resistance to some antibiotics, which can be detected through antimicrobial susceptibility testing. Molecular methods, including PCR, can confirm the identification, especially in complex cases. Moreover, advanced techniques like MALDI-TOF mass spectrometry are increasingly used for precise diagnosis. These diagnostic tools ensure accurate detection of P. penneri in clinical settings. Consequently, early diagnosis is essential for proper treatment and infection control.

Treatment

Treating Proteus penneri infections requires careful selection of antibiotics due to its resistance patterns. It is often resistant to common antibiotics like ampicillin and first-generation cephalosporins. Therefore, doctors frequently turn to broader-spectrum antibiotics such as ciprofloxacin or piperacillin-tazobactam. However, resistance to these drugs can sometimes emerge, complicating treatment further. In cases of severe infection, carbapenems may be used as a last resort. Additionally, antibiotic susceptibility testing is crucial before starting treatment to ensure effectiveness. Biofilm formation by P. penneri makes infections harder to treat and may require higher doses or combination therapy. Moreover, patients with catheter-associated urinary tract infections might need catheter removal or replacement. Proper infection control measures in hospitals are essential to prevent the spread of multidrug-resistant P. penneri. Early diagnosis and tailored antibiotic therapy play a vital role in managing these infections effectively.

Prevention

Keynote

Proteus penneri is a Gram-negative, rod-shaped bacterium primarily found in soil and water. It is part of the Enterobacteriaceae family, closely related to Proteus mirabilis. However, P. penneri differs in its biochemical characteristics, showing resistance to several antibiotics. Additionally, it frequently causes infections like urinary tract infections (UTIs) in hospitalized or immunocompromised patients. Importantly, P. penneri forms biofilms, which increase its resistance to treatment and persistence in infections. Furthermore, it produces urease, an enzyme contributing to the formation of kidney stones by increasing urinary pH. On culture media, it forms smooth colonies, unlike the swarming behavior seen in P. mirabilis. Moreover, antibiotic susceptibility testing is crucial due to its multidrug-resistant nature. Understanding its clinical significance is essential for appropriate diagnosis and treatment. Therefore, P. penneri presents a growing challenge in healthcare, requiring diligent monitoring and control efforts.