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Adrian Maier, Adrian Man, Călin Chibelean, Teodora Cighir, Eniko Nemes-Nagy, Ioana Maier, Ciprian Todea, Oliver Vida and Orsolya Martha

-1326932 4. Tanwar R, Singh SK, Pawar DS. Pyelo-hepatic abscess caused by renal calculi: A rare complication. Indian J Urol. 2013;29(3):249–50. DOI: 10.4103/0970-1591.117260 5. Urinary Tract Obstruction: Obstruction of the Urinary Tract: Merck Manual Home Edition [Internet]. [cited 2014 Jun 22]. Available from: http://www.merckmanuals.com/home/kidney_and_urinary_tract_disorders/obstruction_of_the_urinary_tract/urinary_tract_obstruction.html 6. Zanetti G, Paparella S, Trinchieri A, Prezioso D, Rocco F, Naber KG. Infections and urolithiasis: current clinical

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Antoni Różalski, Agnieszka Torzewska, Magdalena Moryl, Iwona Kwil, Agnieszka Maszewska, Kinga Ostrowska, Dominika Drzewiecka, Agnieszka Zabłotni, Agata Palusiak, Małgorzata Siwińska and Paweł Staçzek

of Proteus penneri clinical strains. Arch. Immunol. Therap. Exp. 52:121-128. DUMANSKI, A.J., HEDELIN, H., EDIN-LILJEGREN, A., BEACHEMIN, D., MCLEAN, R.J.C. 1994. Unique ability of Proteus mirabilis capsule to enhance mineral growth in infectious urinary calculi. Infect. Immun. 62: 2998-3003. FLANNERY, E., MODY, L., MOBLEY, H.L.T. 2009. Identification of a modular pathogenicity island that is widespread among urease-producing uropathogens and shares features with diverse group of mobile elements. Infect. Immun. 77: 4887

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Gulcan Sahal and Isil Seyis Bilkay

[ 1 ]. One of the most important mechanisms playing a role in indwelling device-related urinary tract infections, is known as biofilm formation [ 3 ]. Once P. mirabilis adheres to living tissue or nonliving surfaces, it may form a slimy layer known as a biofilm. The biofilm protects these microorganisms from the host defense system and from antibiotics; often leading to repeated infection by P. mirabilis [ 1 ]. Moreover, P. mirabilis generates ammonia and elevates the pH of the urine to >7.2, promoting precipitation and aggregation of struvite or apatite