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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laboratory and clinical studies on ceftazidime ( CAZ ), a new cephem antibiotic, were carried out in the field of pediatrics. The results were as follows: Antibacterial activities of CAZ against clinically isolated strains of S. pneumoniae, H. influenzae, E. coli and P. aeruginosa were compared with those of cefotaxime (CTX), ceftizoxime (CZX), latamoxef ( LMOX ), cefoperazone (CPZ) and cefmetazole (CMZ), and also with cefsulodin (CFS) and gentamicin (GM) against P. aeruginosa. Against S. pneumoniae and H. influenzae, CAZ was almost as active as CTX, CZX and CPZ. Against E. coli, it was almost as active as CTX, CZX and LMOX . Against P. aeruginosa, it was almost as active as CFS and GM. Serum concentrations and urinary excretion rates after intravenous bolus injection of CAZ at doses of 20 mg/kg and 10 mg/kg for 5 minutes in each 2 cases (4 cases in total) were determined. The mean serum concentrations of CAZ were 78.9 and 52.0 micrograms/ml at 15 minutes, 38.5 and 27.4 micrograms/ml at 1 hour, and 6.5 and 4.8 micrograms/ml at 4 hours, with serum half-lives (T 1/2) of 1.39 and 1.80 hours respectively. Mean cumulative urinary excretion rate within 6 hours after administration was 84.6%. In a patient with chronic renal failure, serum half-life was 3.22 hours and urinary excretion rate within 6 hours was 22.8% (after intravenous bolus injection of CAZ at a dose of 10 mg/kg). CAZ was administered at a dose of 55.5 mg/kg by intravenous bolus injection to a child with purulent meningitis. The levels of CAZ in the cerebrospinal fluid (CSF) at 1 hour after administration were 2.7-38.9 micrograms/ml with CSF/Serum ratios of 3.2-28.8%. Forty-two pediatric patients with various bacterial infections (pyelonephritis 14, tonsillitis 1, bronchopneumonia 3, pneumonia 17, purulent meningitis 1, bacteremia 2, SSSS 1, enterocolitis 3) were treated with CAZ at a daily dose of 49-222 mg/kg t.i.d. or q.i.d. (as a rule 60 mg/kg t.i.d.). The efficacy rate was 97.6% clinically and 97.8% bacteriologically. No adverse reactions were observed except 1 case with mild diarrhea. Abnormal laboratory findings were also only mild; eosinophilia in 1, slight elevation of GOT in 5 and that of GOT & GPT in 3 cases. These results indicate the usefulness of CAZ in the treatment of bacterial infections in children.
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PMID:[Laboratory and clinical studies on ceftazidime in the field of pediatrics]. 637 56

Localized xanthogranulomatous pyelonephritis due to methicillin-resistant Staphylococcus aureus developed in a 41-year-old diabetic patient. She had recurrent bacteremia despite appropriate therapy with vancomycin. Nephrectomy was required for cure and clinical diagnosis. This report emphasizes differences in the clinical presentation and pathogenesis of xanthogranulomatous pyelonephritis caused by S. aureus. Compared with the common form of xanthogranulomatous pyelonephritis caused by gram-negative bacilli, the localized disease due to S. aureus probably results from hematogenous seeding and is not associated with nephrolithiasis or ureteral obstruction. Furthermore, this report indicates that xanthogranulomatous pyelonephritis may be caused by methicillin-resistant S. aureus, a rapidly emerging nosocomial pathogen.
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PMID:Xanthogranulomatous pyelonephritis caused by methicillin-resistant Staphylococcus aureus. 656 Sep 82

Experimental pyelonephritis was produced in mice by the intravenous injection of Pseudomonas aeruginosa. Immune response to infection was studied by passive hemagglutination antibody titers. Vaccination of mice with live P. aeruginosa or culture filtrates (Pseudomonas antigen) induced antibodies and resulted in a high degree of protection against death and pyelonephritis following subsequent hematogenous challenge with the homologous strain. Transfer of immune serum protected mice against death following infection with the homologous strain and with a heterologous strain. However, immune serum failed to protect mice from kidney infection by the heterologous strain. These data indicate that immune serum seemed to protect against early, overwhelming bacteremia but did not prevent a chronic course of kidney infection by a heterologous strain.
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PMID:Effect of active and passive immunization on the development of experimental Pseudomonas aeruginosa pyelonephritis in mice. 678 87

The in vitro attachment of 335 Proteus mirabilis strains from various human sources to human urinary tract epithelial cells was measured. No significant difference in adhesive capacity was found between P. mirabilis strains isolated from the blood of 89 patients with bacteremia, the stools of 36 healthy subjects and 56 patients with diarrhea, and the urine of 62 adults and 92 children with bacteriuria. High mean adhesion values were observed in all groups. The P. mirabilis strains attached only to squamous cells and not to transitional epithelial cells, whereas most of the Escherichia coli strains tested attached to both cell types; strains from patients with acute pyelonephritis attached more often than those from patients with acute cystitis or asymptomatic bacteriuria. The attachment of P. mirabilis to squamous epithelial cells was high about day 15 of the menstrual cycle of the epithelial cell donor, but low at the beginning and the end of the cycle. In contrast, the attachment of E. coli to squamous and transitional epithelial cells did not vary significantly with the menstrual cycle of the cell donor. Differences in adhesion characteristics of E. coli and P. mirabilis may relate to the differences in clinical appearance of urinary tract infections produced by the two organisms.
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PMID:Attachment of Proteus mirabilis to human urinary sediment epithelial cells in vitro is different from that of Escherichia coli. 699 31

Ninety-four cases of pyelonephritis including 20 who had concurrent bacteremia were treated with cefamandole alone or in combination with either gentamicin or tobramycin. Doses of cefamandole ranged from 1--2 g by intermittent intravenous (VI) infusion every 4 to 8 h; gentamicin and tobramycin doses ranged from 1--1.7 mg/kg every 8 h also by intermittent IV infusion. Duration of therapy ranged from 5 to 23 days (mean 7.3 days). Both single and combination therapy successfully treated acute pyelonephritis and bacteremia in all patients. Seven strains of E. coli and one of Klebsiella pneumoniae responsible for initial infection were resistant to cephalothin but sensitive to cefamandole. Relapse with cefamandole sensitive bacteria occurred in 27% of patients receiving only cefamandole and 8% of those patients receiving combination therapy. Reinfection with cefamandole resistant organisms, predominantly Pseudomonas aeruginosa occurred in five patients. One patient had an intrarenal abscess due to E. coli which was successfully treated with 23 days of cefamandole. One patient died. However, death was due to acute pulmonary embolism, not infection. None of the patients receiving cefamandole plus gentamicin or tobramycin experienced a significant decrease in creatinine clearance during or after therapy. Skin rash, mild thrombophlebitis at the IV site and transient elevation of alkaline phosphatase and SGOT were the only side effects noted.
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PMID:Cefamandole alone and combined with gentamicin or tobramycin in the treatment of acute pyelonephritis. 701 May 44

This report describes a patient with group B streptococcal (GBS) bacteremia with pyelonephritis and septic arthritis whose condition failed to improve after two weeks of therapy with penicillin G sodium. The organism was found to be tolerant to penicillin (minimal inhibitory concentration, 0.06 IU/mL; minimal bactericidal concentration [MBC], 10 IU/mL). Antimicrobial synergy with gentamicin sulfate was demonstrated (MBC of penicillin was 0.07 IU/mL in the presence of 2.5 micrograms/mL of gentamicin). Addition of gentamicin to penicillin therapy was associated with clinical improvement. It is suggested that bactericidal rather than inhibitory susceptibility tests be employed as a guide to therapy in serious GBS infections. Where penicillin tolerance is found in association with a poor clinical response to penicillin, addition of an aminoglycoside should be considered. Antimicrobial synergy studies should be performed to demonstrate that a beneficial effect is possible at clinically attainable antibiotic concentrations.
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PMID:Serious infection in an adult due to penicillin-tolerant group B streptococcus. 703 Feb 51

Acute urethral syndrome is effectively treated with a standard course of an appropriate oral antibiotic. Cystitis can be treated similarly but, because it is regarded as benign in normal hosts, may be better treated symptomatically. Acute pyelonephritis requires a parenteral antibiotic because of its frequent association with bacteremia. In chronic pyelonephritis, an oral antibiotic is chosen for long-term use on the basis of its ability to penetrate damaged renal tissue. When urinary tract infection recurs, reinfection must be differentiated from relapse. Reinfection usually requires long-term antimicrobial therapy, but relapse often has a potentially reversible underlying cause and merits extensive diagnostic workup. Chronic prostatitis constitutes a greater therapeutic problem than acute prostatitis because of difficulty with antibiotic penetration.
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PMID:Urinary tract infections. 2. Therapeutic approach. 703 28

A prospective study was done on the clinical, laboratory, radiological, immunological and therapeutic features of acute, symptomatic, bacteremic urosepsis in 34 consecutive, elderly patients who required hospitalization. Urinary tract infection was identified as the most common cause of gram-negative bacteremia in elderly patients admitted to a community hospital. Appropriate antibiotic therapy and a lack of serious associated medical illnesses contributed to the high survival rate. Bacteremia and shock occurring in the wake of pyelonephritis develop more commonly in elderly than in young women. In the elderly patient with bacteremia and pyelonephritis radiographic evaluation invariably demonstrates obstruction to urine flow, calculous disease or abscess. Guidelines are provided for the therapy of acute, symptomatic bacteremic urosepsis.
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PMID:Community-acquired bacteremic urosepsis in the elderly patients: a prospective study of 34 consecutive episodes. 705 Apr 17

Dioxidine (50 mg/kg a day) and carbenicillin (500 mg/kg a day) administered to rats with Ps. aeruginosa hematogenic pyelonephritis for 7 days brought about high therapeutic effect accompanied by bacteremia elimination, noticeable reduction of bacteriuria and dissemination of renal tissue, by improvement of the histological structure of the kidneys as compared with untreated animals. Complete recovery of all the animals (sterilization of the urine and tissue of both the kidneys), and abolition of pyelonephritis signs in the histological structure of the kidneys are attained as a result of combined use of dioxidine and carbenicillin in doses 25 and 250 mg/kg, respectively.
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PMID:[Dioxidine and carbenicillin in Pseudomonas aeruginosa pyelonephritis in rats]. 705 84

We did a prospective study of the clinical, laboratory, radiologic, and therapeutic features of acute, symptomatic, bacterial pyelonephritis in 35 consecutive elderly, noncatheterized patients who required hospitalization. Pyelonephritis had been identified as the most common cause of gram-negative bacteremia in elderly patients admitted to a community hospital. Appropriate antibiotic therapy and, of equal importance, a lack of serious associated medical illnesses contributed to the 97% survival. Two features appear to distinguish acute, symptomatic, bacterial pyelonephritis in elderly women from that in young women: an increased incidence of bacteremia and septic shock. We provide guidelines for the diagnostic evaluation and antibiotic therapy of acute, symptomatic, community-acquired, bacterial pyelonephritis in the elderly.
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PMID:Acute pyelonephritis in the elderly. 707 12


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