# Identification of bacterial small molecule inhibitors of Proteus mirabilis urease activity

> **NIH NIH R21** · STATE UNIVERSITY OF NEW YORK AT BUFFALO · 2022 · $239,250

## Abstract

Project Summary/Abstract
Patients with indwelling urinary catheters have nearly double the mortality rate compared to non-catheterized
patients, in part due to increased colonization by multidrug-resistant organisms, catheter-associated urinary tract
infections (CAUTI), and secondary bacteremia. The Gram-negative bacterium Proteus mirabilis is a predominant
cause of both CAUTI and bacteremia, particularly with long-term catheterization. This bacterium has long been
recognized as a problematic colonizer of the urinary tract due to its potent urease enzyme, which hydrolyzes the
urea in urine to carbon dioxide and ammonia. Bacterial urease activity ultimately increases urine pH, induces
precipitation of polyvalent ions, and causes painful catheter encrustation, blockage, and urinary stones
(urolithiasis). In human patients and animal infection models, P. mirabilis urease activity elicits bladder
obstruction and renal damage and greatly facilitates the development of bacteremia. However, disrupting urease
activity abrogates development of urolithiasis and dramatically reduces the incidence of bacteremia, making
urease a promising target for treating or preventing P. mirabilis CAUTI sequelae. CAUTI is also frequently
polymicrobial, and we have demonstrated that co-infection of P. mirabilis with other uropathogens modulates the
risk of urolithiasis and bacteremia in a urease-dependent manner. Specifically, Enterococcus faecalis and
Providencia stuartii increase the incidence of urolithiasis and bacteremia by enhancing P. mirabilis urease
activity, while Morganella morganii and Enterobacter aerogenes decrease infection severity by dampening P.
mirabilis urease activity. In all cases, modulation of P. mirabilis urease activity is mediated by as-yet unidentified
factors that are secreted, smaller than 3 kDa, and heat-stable. We therefore hypothesize that cell-free
supernatants from urease-modulatory species can be exploited to identify membrane-permeable small
molecules that regulate activity of the cytoplasmic urease enzyme in P. mirabilis and that have strong potential
to be developed into a non-antibiotic approach for treating or preventing P. mirabilis CAUTI sequelae. In Aim 1,
we will determine the mechanism of action of urease modulation by cell-free supernatants focusing on i) direct
interaction with the P. mirabilis urease enzyme and ii) indirect effects on production of urease structural subunits
and the ratio of catalytically-active urease holoenzyme to apoenzyme. In Aim 2, we will conduct a global
metabolomics study to identify small molecule signatures unique to cell-free supernatants from species that
dampen P. mirabilis urease activity. Candidate small molecules revealed through this study will then be
purchased, synthesized, isolated, or enriched for to verity the mechanism by which they decrease P. mirabilis
urease activity. The proposed approach represents both a conceptual and technical innovation in the search for
urease inhibitors, and...

## Key facts

- **NIH application ID:** 10348347
- **Project number:** 1R21AI165979-01
- **Recipient organization:** STATE UNIVERSITY OF NEW YORK AT BUFFALO
- **Principal Investigator:** Chelsie Elizabeth Armbruster
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $239,250
- **Award type:** 1
- **Project period:** 2022-04-13 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10348347

## Citation

> US National Institutes of Health, RePORTER application 10348347, Identification of bacterial small molecule inhibitors of Proteus mirabilis urease activity (1R21AI165979-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10348347. Licensed CC0.

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