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We report a patient with proteus syndrome who has epidermal nevus, right-sided asymmetric growth of extremities, pelvis, vertebrae and hemimegalencephaly. This patient also had enlargement of the liver which is not reported before in the proteus syndrome.
Sensitivity to 9 antibiotics of 1040 strains of Proteus belonging to the serological groups 03, 05, 06, 07, 010, 011, 013, 023, 024, 026, 027, 028 and 030 was studied. It was found that the above strains were sensitive and highly sensitive to the aminoglycosides and streptomycin, slightly sensitive to levomycetin and resistant to tetracyclines, erythromycin and penicillin. All the strains were polyresistant and 99.6 per cent of them were resistant to 4--9 antibiotics. Ten types of resistance were found. Proteus strains with the resistance type PETOtCht were most common. No relation between the occurrence of the strains of various serological groups and the character and level of their resistance to the antibiotics was found.
An electron microscope study of the nuclear membrane of Amoeba proteus by thin sectioning techniques has revealed an ultrastructure in the outer layer of the membrane that is homologous to the pores and annuli observed in the nuclear membranes of many other cell types studied by these techniques. An inner honeycombed layer apparently unique to Amoeba proteus is also described.
The tryptophanase (tna) operon of Proteus vulgaris was cloned and characterized and found to be organized similarly to the tna operon of Escherichia coli. Both operons contain two major structural genes, tnaA and tnaB, that encode tryptophanase and a tryptophan permease, respectively. tnaA of P. vulgaris is preceded by a transcribed leader region, encoding a 34-residue leader peptide, TnaC, that contains a single tryptophan residue. The tnaC coding region also has a boxA-like sequence. Regulatory studies performed in P. vulgaris, and with a plasmid carrying the P. vulgaris tna operon in E. coli, established that expression of the Proteus operon was induced by tryptophan and was subject to catabolite repression. Site-directed mutagenesis studies established that translation of the tnaC coding region was essential for induction. Synthesis of the P. vulgaris leader peptide was demonstrated in an in vitro coupled transcription-translation system. Interestingly, the 5 amino acid residues of the TnaC peptide surrounding the sole tryptophan residue are identical in P. vulgaris and E. coli. We conclude that the tna operon of P. vulgaris is also regulated by tryptophan-induced transcription antitermination. Homology of tryptophanase and tryptophan permease of P. vulgaris to related proteins from other species is described.
Serological characterization of the first collection of the 20 Proteus penneri strains is presented. All anti-0 sera were examined in microagglutination, semi-quantitative precipitation and passive hemagglutination tests. Some P. penneri lipopolysaccharides showed strong cross-reactivity in passive hemagglutination additionally confirmed by inhibition in this test. Serological similarity between species within genus Proteus is discussed.
This study was carried out to determine increased level of antibodies to certain bacteria in rheumatoid arthritis (RA) patients. Fifty RA patients and 25 each of those suffering from osteoarthritis (OA) and healthy controls were tested for antibodies to somatic ('O) and flagellar ('H') antigens of Proteus mirabilis, Escherichia coli, and for antibodies to 'O' antigen of Klebsiella pneumoniae by standard tube agglutination method. Anti-Proteus antibodies against 'O' and 'H' antigens could be demonstrated in 70% and 64% RA cases respectively, and were statistically significant. Antibodies could be demonstrated against E. coli 'O' and 'H' antigens in 86% and 92% RA cases respectively, and were statistically significant. Against K. pneumoniae 'O' antigen, no antibody could be demonstrated in any of RA and OA cases, and healthy controls. Of the 50 RA patients, 30 had raised CRP levels. Antibodies against P. mirabilis and E. coli antigens appeared to be independent from CRP. Thus a specific elevation in the immune response to P. mirabilis and E. coli has been demonstrated in patients with RA from India.
Proteus syndrome is a recently described hamartomatous condition characterized by macrodactyly, hemihypertrophy, subcutaneous (s.c.) tumors, epidermal nevi, and skull anomalies. Two new cases are described to illustrate the diagnostic features and the orthopedic problems associated with this rare syndrome. Review of available literature shows that 61 patients with proteus syndrome commonly develop macrodactyly, limb overgrowth, spinal deformity, hip dysplasia, genu valgum, exostoses, joint contractures, and hindfoot deformities.
The authors describe clinical pathologic findings in a patient with a structural chromosome 16 anomaly in mosaic distribution with the phenotypic characteristics of the Proteus syndrome. This is the 1st report showing that the Proteus syndrome may be associated with a chromosome 16 anomaly; while previous findings suggested that this syndrome was associated with a modification of chromosome 1. As the pathologic hypothesis of this syndrome possibly involves lethal genes in somatic mosaicism, responsible for control of cellular proliferation and/or alteration in the mechanism of action of some growth factors, chromosomal alterations found in the patient described in this work may suggest the location of the genes involved in this syndrome.
When studying sensitivity of Proteus mirabilis to bactericide effect of blood serum the resistance to alternative way of the complement activation was found in a number of strains. The population of cells with morphologically determinable changes of the surface structures resistant to bactericide effect of the serum is formed as affected by the blood serum of the culture P. mirabilis. Proteus proteases capable to inactivate the complement components are one of the factors of P. mirabilis resistance to bactericide effect of the complement.
Proteus syndrome is a rare congenital condition with various clinical features such as hemihypertrophy, macrodactyly, subcutaneous masses, brain-like hyperplasia of the soles and/or palms, epidermal naevi and scoliosis with other mesodermal malformations. Multifocal overgrowth can affect various tissues causing severe functional and cosmetic disability, but intellectual and language development are mostly normal. Orthopaedic problems include macrodactyly, hindfoot deformity, limb length inequality, genu valgum and scoliosis. Usually, scoliosis does not respond to bracing, and surgical intervention may be required. Despite surgical correction, instrumentation and fusion, progression of deformity can occur. The authors describe a case with a Th7-L2 scoliosis, which completely relapsed, 20 months after posterior instrumented fusion. Surgery should not be undertaken lightly, given the abnormal growth potency typical for Proteus syndrome.
The literature on clinical and roentgenographic findings of Proteus syndrome is reviewed. Two patients with Proteus syndrome who exhibited skeletal deformities and characteristic features such as limb length discrepancy, skin lesions, and soft tissue tumors are reported. Persistent difficulties in treating malformed spines and unequal legs, as well as unpredictable tissue reaction to trauma, are discussed.
The experiments on 52 rabbits have been carried out to show the possibility to use Proteus antigen with high content of H-component (H1; H2; H3 Proteus antigens are most frequently found) for active immunization to make highly specific humoral immunity. The optimal scheme of immunization consists of 3 subcutaneous injections in doses of 0.25-0.25-0.5 mg of antigen within 7 days intervals and 0.25 mg dose of single revaccination. The duration of cycle immunization is 14 days.
Tests were carried out on 16 strains of Proteus to determine the smallest amount of alkylarylsulfone that prevents complete swarming of the bacteria, restricting it to band only 1-2 mm wide. This was achieved by adding 0.0075% of detergent to Gassner's medium. The result was easily visible on the surface of inoculated plates. It was also shown that this inhibitory effect on the flagellar apparatus of Proteus and also Salmonella was purely temporary being due to a reversible reduction of this apparatus.
We examined in vitro susceptibilities of 3,109 isolates belonging to 5 species of Proteeae to 2 penicillins, 5 cephems and 2 aminoglycosides. The isolates were collected from 69 hospital laboratories throughout Japan between 1986 and 1988. Minimal inhibitory concentrations were determined using the agar dilution method with inoculation of 10(8) cells/ml of bacteria. Proteus mirabilis had marked susceptibilities to the penicillins and cephems tested. Proteus vulgaris and Morganella morganii were similar in their susceptibilities to ampicillin (ABPC), piperacillin (PIPC), cefazolin (CEZ), cefotiam (CTM), latamoxef, gentamicin (GM) and netilmicin (NTL), but M. morganii was slightly more resistant to cefmetazole and ceftizoxime (CZX) than P. vulgaris. Providencia rettgeri also had a susceptibility pattern similar to that of P. vulgaris, except that P. rettgeri showed higher resistances to CZX, GM and NTL. Providencia stuartii had a very similar susceptibility pattern to P. rettgeri, but P. stuartii was much more resistant to GM and NTL than the latter. Some major differences on susceptibilities were clearly evident among the 5 species of Proteeae tested. Notable species-specific differences included higher susceptibilities of P. mirabilis to ABPC, PIPC, CEZ and CTM than others and stronger resistances of P. rettgeri and P. stuartii to GM and NTL.
Some biological features of a deep P. mirabilis 17301 R mutant isolated from the urine of a patient with chronic UTI were studied and compared with similar features of P. mirabilis S forms and five induced Proteus R mutants of different chemotypes. There were no differences in lethal toxicity and adhesion to human uroepithelial cells. Of all the R mutants tested, two of them, 17301 and R4, exhibited strong cell-bound hemolytic activity. The P. mirabilis R 17301 was characterized as the most invasive (tested in L929 mouse fibroblasts) compared to the other Proteus S and R forms. The structure of PS from a clinical R mutant investigated and the results of serological studies prove that this mutant belongs to the Rc chemotype.
Antagonistic activity of 2 fresh isolates and 3 collection strains of Pseudomonas aeruginosa against 177 microbial strains was determined with the method of late antagonism. Among the microbial strains there were 56 staphylococcal strains isolated from patents and carriers. 38 nontypable colon bacilli isolated from healthy persons, 59 enteropathogenic colon bacilli of various serogroups, 12 strains of Proteus and 12 colon bacilli, carriers of multiple drug resistance factors (R factors). All the cultures were sensitive to the antagonistic action of 5 or at least 3 strains of Pseudomonas used in the study. The most active antagonists were the fresh isolates of Pseudomonas as compared to the collection strains. Among the staphylococci S. aureus proved to be the most resistant to the antagonistic action of Pseudomonas as compared to S. epidermidis, the same as the strains isolated from carriers as compared to the strains isolated from patients. As for the enteric bacilli the most resistant were the strains of Proteus. Acquiring of transmissive R factors by the colon bacilli markedly increased their sensitivity to the antagonistic action of Pseudomonas.
Pefloxacin, a new piperazinyl substituted quinolone derivative, reduced at sub-MICs (Minimal Subinhibitory Concentrations: four times lower than Minimal Inhibitory Concentrations) the in vitro adherence of Proteus-Providencia spp. to squamous epithelial cells obtained from the urinary tract. The decrease of adherence was about 30% and 50% after 1 h and, respectively, 16-18 h of incubation with pefloxacin. This finding suggests that pefloxacin may play a role in determining the in vivo adhesion of Proteus-Providencia spp. on the urinary tract and consequently the expression of bacterial pathogenic potency.
Resistance markers to individual antibiotics are transmitted in E. coli with the same frequency in the shape of a uniform linkage group, and in Proteus mirabilis--with a different one. Possibly in Proteus mirabilis plasmide R6 dissociated, this being expressed in a different incidence of transconjugates, characterized by a different set of antibiotic resistance genes. Tetracyclin resistance gene can be transmitted in P. mirabilis without being bound with other resistance determinants and with the functioning Tra-operon. The expression of individual antibiotic resistance genes of plasmide R6 in P. mirabilis differed, i.e. tetracycline resistance was inducible, and to kanamycin and chloramphenicol--constitutional. The level of expression of the gene controlling the tetracycline resistance was in noninduced condition in P. mirabilis, lower than in E. coli, P. mirabilis containing no R-factor possessed an inducible resistance mechanism to tetracycline, as in case of P. mirabilis strains containing R-factors.