Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

E. coli is the main agent of uncomplicated urinary tract infections (UTIs) and accounts for more than 85% of recurrent cystitis and at least 35% of recurrent pyelonephritis. Despite the widespread availability of antibiotics, UTIs remain the most common bacterial infection in the human population. It is currently advised that the clinical administration of antibiotics against the pathogenic bacteria should be prohibitted due to the emergence of multidrug resistant (MDR) bacterial strains. Therefore, newer and more effective antimicrobials are in demand to treat such cases. One hundred and thirty six urine samples were collected from UTI patients. E. coli was isolated from 85 samples, out of which 33% were resistant to common antibiotics. The isolates were decreasingly resistant to ampicillin, tobramycin, augmentin, nalidixic acid, cefuroxime, nitrofurantoin, kanamycin, pipemidic acid, chloramphenicol, cefotaxime, cefamendol, ofloxacin, ceftizoxime, norfloxacin and amikacin. The anti-inflammatory drug diclofenac exhibited significant antibacterial activity against common bacterial strains both in vitro and in vivo. The present work was conducted to evaluate the in vitro inhibitory effect of this drug on the clinically isolated strains of E. coli in hospitals. All the isolates were sensitive to diclofenac, with MIC values ranging from 5-50 microg/mL. The MIC90 value of the drug was 25 microg/mL. Therefore, it may be suggested that diclofenac has the capacity to treat UTI caused by E. coli.
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PMID:Diclofenac in the management of E. coli urinary tract infections. 1709 68

Urinary tract infection (UTI) is a common clinical disorder in younger infants and children and may result in permanent renal damage. The inflammatory cytokines interleukin (IL)-6 and IL-8 play an important role in response to bacterial infection. This prospective study investigated the association between serum and urine IL-6 and IL-8 levels and acute pyelonephritis confirmed by (99m)Tc-dimercaptosuccinic acid (DMSA) scan. A total of 78 children aged 1-121 months with a diagnosis of first-time febrile UTI were included. The following inflammatory markers were assessed: fever; white blood cells count (WBC); C-reactive protein (CRP); and serum and urine IL-6 and IL-8. The patients were divided into the acute pyelonephritis group (n=42) and the lower UTI group (n=36) according to the results of DMSA scan. Fever, WBC and CRP levels were significantly higher in children with acute pyelonephritis than in those with lower UTI (all p <0.001). Significantly, higher initial serum and urine IL-6 and IL-8 levels were found in children with acute pyelonephritis than in those with lower UTI (all p <0.001). Serum and urine IL-6 in children with acute pyelonephritis were positively correlated with fever, CRP and leucocyturia. These results indicate that both serum and urine IL-6 and IL-8 levels, particularly IL-6, are useful diagnostic tools for early recognition of acute pyelonephritis in febrile children.
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PMID:Serum and urine levels of interleukin-6 and interleukin-8 in children with acute pyelonephritis. 1737 89

Fever of unknown origin is alarming phenomenon in childhood. Diagnostic procedures should be focused on severe bacterial infection: pyelonephritis, pneumonia and other respiratory tract infections such as mastoiditis and sinusitis in particular ethmoiditis. The principles of treatment and diagnostics were discussed depending on age and general status of the child.
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PMID:[Fever of unknown origin--pyelonephritis? Pneumonia? Mastoiditis? Ethmoiditis?]. 1843 3

The accuracy of using body temperature, serum amyloid A (SAA), C-reactive protein (CRP) and interleukin-6 (IL-6) in the work-up for early or late step-down therapy after an initial course of intravenous cefuroxime was investigated. Eighty-one hospitalized patients with an initial course of cefuroxime were retrospectively classified with one of the following diagnoses: bacterial infection without known focus, pneumonia, bronchitis, pyelonephritis, skin and soft-tissue infections or fever of other origin. The majority of the patients had sepsis (91% or 74/81) of whom 6 patients had severe sepsis. The inter-individual variability of body temperature, SAA, CRP and IL-6 was considerable. The time course of SAA and CRP during the first 24 h in patients with sepsis with a short duration of illness but without septic shock showed increasing levels during the initial course of intravenous therapy. In contrast, body temperature and IL-6 decreased, regardless of illness duration. Beyond 24 h, all 4 biomarkers declined, again regardless of the duration of illness. After the initial course of cefuroxime, biomarkers were non-distinguishing in terms of guidance in the judgement of early or late step-down therapy. Further studies are proposed for biomarker guidance antibiotic therapy in sepsis patients without septic shock.
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PMID:The time course of body temperature, serum amyloid A protein, C-reactive protein and interleukin-6 in patients with bacterial infection during the initial 3 days of antibiotic therapy. 1962 62

Female Sprague-Dawley rats (n = 100; age, 3 wk) were fed diets that included a vitamin premix and either albumin or milk powder. Rats fed the albumin diet gained weight more slowly than did the other group. Between 19 and 28 wk of being fed the albumin diet, 12 rats died of bacterial cystitis and pyelonephritis. In addition, 2 more rats from the same dietary group developed peritonitis after ovariohysterectomy. Examination of the 44 rats fed the albumin diet that completed the 34-wk experiment revealed pyelonephritis in 68%, cystitis in 66%, urolithiasis in 27%, and nephrolithiasis in 5%. Squamous metaplasia of the transitional epithelium was present in all 44 rats, although other epithelia were histologically normal. Vitamin A deficiency was diagnosed after analyses of blood and liver samples. Analysis of the vitamin premix revealed approximately 25% of the expected amount of vitamin A. Because the milk powder contained sufficient vitamin A, deficiency did not occur in rats fed the milk powder diet. The major consequences of vitamin A deficiency in the rats were squamous metaplasia, bacterial infection, and calculus formation within the urinary tract. This report illustrates the importance of careful formulation and storage of vitamin premixes used in experimental diets. Vitamin A deficiency should be considered in rats with decreased weight gain and urinary tract disease even if ocular lesions are not present.
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PMID:Cystitis, pyelonephritis, and urolithiasis in rats accidentally fed a diet deficient in vitamin A. 1993 Aug 29

The blood level of C-reactive protein and erythrocyte sedimentation rate reflect inflammation and are useful for the diagnosis of bacterial infection. However, these markers are often increased in other diseases such as rheumatoid arthritis. Procalcitonin (PCT), a precursor of calcitonin, was reported to be produced at the time of bacterial infection. The detection of PCT in blood is especially useful for the diagnosis of bacteremia. PCT is also considered to be useful for the diagnosis of limited bacterial infections, such as pneumonia, meningitis, and pyelonephritis, although the level in these conditions could be much less than that in bacteremia. There are two methods for the measurement of PCT in Japan: the chemiluminescence enzyme immunoassay (CLEIA) and immunochromatography assay (IC). CLEIA is quantitative and is sensitive for detecting a low level of PCT. IC is semi-quantitative and is useful for bed-side testing. It is important to understand the features of these two methods of PCT and to use them in appropriate situations.
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PMID:[Diagnosis of bacterial infection using procalcitonin]. 2056 Apr 61

Acute pyelonephritis is a common bacterial infection in children. The recommended treatment in Denmark is intravenous ampiciline and gentamycin for at least three days followed by oral antibiotics. The available evidence indicates that oral antibiotics may be as effective as initial intravenous treatment of children with a first attack of pyelonephritis. However, there are no Danish microbiological studies covering broad-spectrum oral antibiotics to children with pyelonephritis. This impedes generalisation to Danish practice.
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PMID:[Oral versus intravenous antibiotic therapy for pyelonephritis in the paediatric patient--a survey of a Cochrane review]. 2082 32

INTRODUCTION. Urinary tract infection is the most common serious bacterial infection in children. The aim of this study was to compare the value of different laboratory and imaging techniques in detecting renal involvement in acute pyelonephritis. MATERIALS AND METHODS. In a cross-sectional study of patients 1 month to 14 years of age diagnosed with urinary tract infection were examined with systemic inflammatory markers, renal ultrasonography, voiding cystourethrography (VCUG), and technetium Tc 99m dimercaptosuccinic acid ((99m)Tc-DMSA) renal scintigraphy. A total of 1467 pediatric patients were eligible for treatment of pyelonephritis. Evaluations included a complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), urinalysis, urine culture, and measurement of serum blood urea nitrogen and creatinine levels. RESULTS. The results of (99m)Tc-DMSA scans were normal in 20.2%, mild decreased cortical uptake in 45.0%, moderate decreased cortical uptake in 12.3%, severe decreased cortical uptake in 12.0%, and decreased cortical function plus irregularity or scar formation in 10.5%. Voiding cystourethrography showed vesicoureteral reflux in 25.9%. The sensitivity of (99m)Tc-DMSA for prediction of vesicoureteral reflux was 84.1% with a negative predictive value of 80.6%. Significant differences were found in the level of blood leukocyte count (P = .03), urine leukocyte count (P = .003), ESR (P = .008), and age (P = .04) between patients with normal and abnormal (99m)Tc-DMSA scan results. CONCLUSIONS. We found that in patient with clinical signs of pyelonephritis, (99m)Tc-DMSA renal scintigraphy can detect pyelonephritis more accurately than the other inflammatory and imaging tests.
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PMID:Technetium Tc 99m dimercaptosuccinic acid renal scintigraphy in children with acute pyelonephritis: correlation with other imaging tests. 2085 70

The progression of a natural bacterial infection is a dynamic process influenced by the physiological characteristics of the target organ. Recent developments in live animal imaging allow for the study of the dynamic microbe-host interplay in real-time as the infection progresses within an organ of a live host. Here we used multiphoton microscopy-based live animal imaging, combined with advanced surgical procedures, to investigate the role of uropathogenic Escherichia coli (UPEC) attachment organelles P and Type 1 fimbriae in renal bacterial infection. A GFP+ expressing variant of UPEC strain CFT073 and genetically well-defined isogenic mutants were microinfused into rat glomerulus or proximal tubules. Within 2 h bacteria colonized along the flat squamous epithelium of the Bowman's capsule despite being exposed to the primary filtrate. When facing the challenge of the filtrate flow in the proximal tubule, the P and Type 1 fimbriae appeared to act in synergy to promote colonization. P fimbriae enhanced early colonization of the tubular epithelium, while Type 1 fimbriae mediated colonization of the center of the tubule via a mechanism believed to involve inter-bacterial binding and biofilm formation. The heterogeneous bacterial community within the tubule subsequently affected renal filtration leading to total obstruction of the nephron within 8 h. Our results reveal the importance of physiological factors such as filtration in determining bacterial colonization patterns, and demonstrate that the spatial resolution of an infectious niche can be as small as the center, or periphery, of a tubule lumen. Furthermore, our data show how secondary physiological injuries such as obstruction contribute to the full pathophysiology of pyelonephritis.
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PMID:Uropathogenic Escherichia coli P and Type 1 fimbriae act in synergy in a living host to facilitate renal colonization leading to nephron obstruction. 2138 70

Urinary tract infection (UTI) is the most common bacterial infection in renal transplant recipients. To date there are no guidelines on antibiotic prophylaxis for UTI in this population. We conducted a systematic review and meta-analysis of randomized controlled trials comparing antibiotic prophylaxis vs. placebo, no intervention, or different antibiotics, all beginning postoperatively and continued for at least 1 month during the first 6 months post transplantation. The search included CENTRAL, PubMed, LILACS, and relevant conference abstracts up to August 2009. The primary outcome was graft loss. Six trials were included in this review, including 545 patients. No significant difference was seen in graft loss (risk ratio [RR] 0.99, 95% confidence interval [CI] 0.91-1.81). Prophylaxis lowered the risk for developing sepsis with bacteremia by 87% (RR 0.13, 95% CI 0.02-0.7) and the risk for developing bacteriuria (symptomatic or asymptomatic) by 60% (RR 0.41, 95% CI 0.31-0.56; 3 trials). Symptomatic UTI and pyelonephritis were not reported. No significant reduction was found in all-cause mortality and adverse events rates; conflicting results were reported for the development of resistant bacteria. Very few trials assessed the efficacy of prophylaxis for UTI following renal transplantation. Prophylaxis reduced bacteriuria and sepsis with bacteremia; effects on graft survival could not be demonstrated.
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PMID:Antibiotic prophylaxis for urinary tract infections in renal transplant recipients: a systematic review and meta-analysis. 2152 35


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