Proteus

Clasificación

Características Generales

Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus spp.

• Estructura: bacilos
• Tinción de Gram: gram-negativos
• Requerimiento de oxígeno: anaeróbios facultativos
• Fermentación de lactosa: no fermentan la lactosa
• Enzimas o pruebas bioquímicas:
  • Oxidasas negativos
  • Fuerte actividad de ureasa
  • Indol: positivo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Proteus vulgaris Proteus vulgaris A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that occurs in soil, fecal matter, and sewage. It is an opportunistic pathogen and causes cystitis and pyelonephritis. Proteus ( P. vulgaris P. vulgaris A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that occurs in soil, fecal matter, and sewage. It is an opportunistic pathogen and causes cystitis and pyelonephritis. Proteus); negativo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum P. mirabilis P. mirabilis A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is frequently isolated from clinical specimens. Its most common site of infection is the urinary tract. Proteus
• Motilidad en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum enjambre (la motilidad del organismo tiene un efecto de dispersión sobre la placa de agar sangre)
• Productores de H₂S (sulfuro de hidrógeno) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum agar hierro triple azúcar
• Enfermedades asociadas:
  • Infección del tracto urinario (ITU)
  • Infección de tejidos blandos
  • Infección intraabdominal

Especies clínicamente relevantes

• P. mirabilis P. mirabilis A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is frequently isolated from clinical specimens. Its most common site of infection is the urinary tract. Proteus
• P. vulgaris P. vulgaris A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that occurs in soil, fecal matter, and sewage. It is an opportunistic pathogen and causes cystitis and pyelonephritis. Proteus

Epidemiología

• P. mirabilis P. mirabilis A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is frequently isolated from clinical specimens. Its most common site of infection is the urinary tract. Proteus: etiología del 90% de las infecciones por Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus, más comúnmente ITU
• ITU por Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus:
  • 5% de las ITU adquiridas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hospital
  • 10%–15% de infecciones complicadas (especialmente ITU asociada a sonda urinaria)
• Las infecciones por P. mirabilis P. mirabilis A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is frequently isolated from clinical specimens. Its most common site of infection is the urinary tract. Proteus se pueden adquirir en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la comunidad, mientras que el resto proviene principalmente de hospitales y centros de cuidado a largo plazo.

Patogénesis

Reservorios y transmisión

• Reservorios:
  • Flora normal del tracto intestinal humano
  • Medio ambiente (suelo y agua)
• Transmisión: propagación al AL Amyloidosis tracto urinario a través de contaminación fecal

Factores de virulencia

• Fimbrias o pili Pili Filamentous or elongated proteinaceous structures which extend from the cell surface in gram-negative bacteria that contain certain types of conjugative plasmid. These pili are the organs associated with genetic transfer and have essential roles in conjugation. Normally, only one or a few pili occur on a given donor cell. This preferred use of ‘pili’ refers to the sexual appendage, to be distinguished from bacterial fimbriae, also known as common pili, which are usually concerned with adhesion. Salmonella:
  • Proyecciones superficiales que permiten la unión al AL Amyloidosis tejido huésped
  • Inicia la liberación de interleuquinas
• Motilidad de Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus (“diferenciación de células en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum enjambre”):
  • Formas de flagelos largos
  • Facilita la invasión del tracto urinario
• Ureasa:
  • Da como resultado la hidrólisis de la urea Urea A compound formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. Urea Cycle, liberando amoníaco
  • La orina se vuelve alcalina, lo que conduce a la formación de:
    • Estruvita (fosfato amónico magnésico) y cristales de carbonato–apatito
    • Biopelículas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria catéteres
    • Cálculos/piedras
• Endotoxina:
  • Componente de la pared celular
  • Al AL Amyloidosis invadir el torrente sanguíneo, desencadena una respuesta inflamatoria en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock

Proceso de enfermedad

• ITU y cálculos renales:
  • Factores de riesgo de infección:
    • Colonización de la vagina Vagina The vagina is the female genital canal, extending from the vulva externally to the cervix uteri internally. The structures have sexual, reproductive, and urinary functions and a rich blood supply, mainly arising from the internal iliac artery. Vagina, Vulva, and Pelvic Floor: Anatomy
    • Sondas urinarias
    • Anormalidades del tracto urinario (estenosis, válvulas y cálculos)
  • Infección persistente → ↑ producción de amoníaco → formación de cálculos
  • Se desarrollan cálculos coraliformes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy renal → obstrucción → insuficiencia renal
  • Los LOS Neisseria cálculos también sirven como nido para infecciones recurrentes.
• Otras infecciones:
  • La bacteriemia se desarrolla comúnmente a partir de una ITU
  • Infección del sitio quirúrgico/tejidos blandos (úlceras de decúbito y diabéticas) y osteomielitis (de un sitio contiguo)
  • Neumonía ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum entornos hospitalarios y de atención a largo plazo)
  • Abscesos intraabdominales
  • Meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis neonatal (a menudo procedente del ombligo)

Presentación Clínica

• Infecciones del tracto urinario:
  • La orina puede tener un olor a amoníaco.
  • Disuria, piuria, dolor Dolor Inflammation suprapúbico y polaquiuria
  • Si tiene pielonefritis, los LOS Neisseria síntomas pueden incluir fiebre, dolor Dolor Inflammation de costado, náuseas y/o vómitos
• Cálculo renal:
  • Los LOS Neisseria cálculos pequeños pueden ser asintomáticos.
  • Fiebre, dolor Dolor Inflammation de costado, hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cálculos complicados con infección
• Bacteriemia:
  • Fiebre, escalofríos, dolor Dolor Inflammation abdominal/flanco con síntomas de ITU
  • Taquicardia, hipotensión en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos severos
• Infecciones de piel y tejidos blandos: herida(s) abierta(s) o úlceras, signos de celulitis

Diagnóstico y Tratamiento

Diagnóstico

• Muestra dictada por la localización de la enfermedad:
  • Orina
  • Sangre
  • Pus
• Frotis y cultivo con tinción de Gram:
  • Efecto de “enjambre” (difusión) sobre la placa de agar sangre
  • Colonias no fermentadoras de lactosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum eosina–azul de metileno o agar de MacConkey
  • Producción de H₂S en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum agar hierro triple azúcar
• Otros estudios de laboratorio:
  • Análisis de orina:
    • Orina alcalina
    • Esterasa leucocitaria positiva, nitritos
    • Bacteriuria Bacteriuria The presence of bacteria in the urine which is normally bacteria-free. These bacteria are from the urinary tract and are not contaminants of the surrounding tissues. Bacteriuria can be symptomatic or asymptomatic. Significant bacteriuria is an indicator of urinary tract infection. Urinary Tract Infections (UTIs) in Children microscópica
    • Piuria
  • Hemograma: puede mostrar leucocitosis
  • Creatinina: anormal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la obstrucción crónica, causando insuficiencia renal
• Imagenología:
  • Radiografía abdominal: muestra cálculos renales
  • Ultrasonido y tomografía computarizada (TC):
    • Detecta cálculos y cambios renales (e.g., absceso, hidronefrosis)
    • Se obtiene si la infección no responde al AL Amyloidosis tratamiento inicial

Tratamiento

• Antibióticos para la infección:
  • Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus spp.: naturalmente resistente a la nitrofurantoína
  • Opciones:
    • Trimetoprim–sulfametoxazol, quinolonas, cefalosporinas
    • Cobertura amplia y curso de tratamiento más largo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ITU complicadas
  • Ajustar el régimen según las pruebas de sensibilidad.
• Tratamiento quirúrgico de los LOS Neisseria cálculos renales:
  • Los LOS Neisseria cálculos renales de estruvita por una infección por Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus deben removerse.
  • Previene resultados clínicos graves (e.g., insuficiencia renal)
  • Elimina fuentes de infección recurrente

Comparación con Bacterias Asociadas a ITU

Escherichia coli Escherichia coli The gram-negative bacterium Escherichia coli is a key component of the human gut microbiota. Most strains of E. coli are avirulent, but occasionally they escape the GI tract, infecting the urinary tract and other sites. Less common strains of E. coli are able to cause disease within the GI tract, most commonly presenting as abdominal pain and diarrhea. Escherichia coli (E. coli) y Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus spp. son etiologías comunes de infección del tracto urinario.

Relevancia Clínica

• Pielonefritis aguda: infección de la pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy renal con afectación del parénquima renal. La infección ascendente con E. coli es, por mucho, la causa más común, pero la cistitis por Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus spp. también puede provocar pielonefritis. Los LOS Neisseria síntomas típicos son dolor Dolor Inflammation de costado, fiebre y escalofríos con disuria. El tratamiento es con antibióticos.
• Pielonefritis xantogranulomatosa: pielonefritis crónica que se desarrolla comúnmente por obstrucción renal debido a cálculos infectados. La pielonefritis xantogranulomatosa se asocia con tejido granulomatoso con macrófagos cargados de lípidos, que destruyen el riñón afectado y puede ocurrir en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la infección por Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus, así como en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la infección por otras bacterias que causan ITU.
• Prostatitis Prostatitis Prostatitis is inflammation or an irritative condition of the prostate that presents as different syndromes: acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain, and asymptomatic. Bacterial prostatitis is easier to identify clinically and the management (antibiotics) is better established. Prostatitis aguda: infección de la próstata. Escherichia coli Escherichia coli The gram-negative bacterium Escherichia coli is a key component of the human gut microbiota. Most strains of E. coli are avirulent, but occasionally they escape the GI tract, infecting the urinary tract and other sites. Less common strains of E. coli are able to cause disease within the GI tract, most commonly presenting as abdominal pain and diarrhea. Escherichia coli y Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus spp. se encuentran entre los LOS Neisseria agentes causales. Los LOS Neisseria pacientes tienen fiebre, escalofríos, disuria, dolor Dolor Inflammation perineal y, en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos graves, retención urinaria. El tacto rectal muestra una próstata inflamada y sensible y el análisis de orina indica infección. El tratamiento es con antibióticos.
• Nefrolitiasis: la infección por Proteus Proteus Proteus spp. are gram-negative, facultatively anaerobic bacilli. Different types of infection result from Proteus, but the urinary tract is the most common site. The majority of cases are caused by Proteus mirabilis (P. mirabilis). The bacteria are part of the normal intestinal flora and are also found in the environment. Proteus se asocia con cálculos de estruvita, que se forman en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina alcalina. Otras composiciones de cálculos incluyen cristales de ácido úrico, cristales de fosfato u oxalato de calcio y cristales de cistina. La mayoría de los LOS Neisseria cálculos contienen calcio. El análisis de los LOS Neisseria cálculos ayuda a diferenciar la composición, porque esto ayuda a determinar las enfermedades relacionadas que contribuyen a la litiasis.