Abstract
The emergence of biofilm-forming, multi-drug-resistant (MDR) Proteus mirabilis infections is a serious threat that necessitates non-antibiotic therapies. Antibiotic susceptibility and biofilm-forming activity of P. mirabilis isolates from urine samples were assessed by disc diffusion and crystal violet assays, respectively. Antimicrobial activities of probiotic Lactobacilli were evaluated by agar diffusion. Antibiofilm and anti-adherence activities were evaluated by crystal violet assays. While most P. mirabilis isolates were antibiotic-resistant to varying degrees, isolate P14 was MDR (resistant to ceftazidime, cefotaxime, amoxicillin-clavulanic acid, imipenem, ciprofloxacin, and amikacin) and formed strong biofilms. Cultures and cell-free supernatants of Lactobacillus casei and Lactobacillus reuteri exhibited antimicrobial and antibiofilm activities. The 1/16 concentration of untreated supernatants of L. casei and L. reuteri significantly reduced mature biofilm formation and adherence of P14 by 60% and 72%, respectively (for L. casei), and by 73% each (for L. reuteri). The 1/8 concentration of pH-adjusted supernatants of L. casei and L. reuteri significantly reduced mature biofilm formation and adherence of P14 by 39% and 75%, respectively (for L. casei), and by 73% each (for L. reuteri). Scanning electron microscopy (SEM) confirmed eradication of P14’s biofilm by L. casei. L. casei and L. reuteri could be utilized to combat Proteus-associated urinary tract infections.
Highlights
Proteus mirabilis is one of the most common pathogens associated with urinary tract infections (UTI) [1,2]
We have previously shown that probiotic lactobacilli inhibited growth, biofilm formation, and gene expression of Streptococcus mutans [17]
Activity of the tested antimicrobial agents against P. mirabilis isolates was evaluated according to CLSI standards [32]
Summary
Proteus mirabilis is one of the most common pathogens associated with urinary tract infections (UTI) [1,2]. It can cause surgical wound infections, biliary tract infections, wound infections, and nosocomial infections [3]. P. mirabilis poses a major challenge in infection management as it produces AmpC β-lactamases and extended spectrum β-lactamases [6]. It can develop complex biofilms with accumulated layers of polysaccharides in which sessile cells are embedded, which adds to the severity of the infection [7]. The severity, chronicity, and dissemination of Proteus infections have been mainly attributed to its ability to form biofilms [7]
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