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)

We have evaluated 283 consecutive hospital acquired urinary tract infections (HAUTI) in a University hospital (incidence 5.6% of admissions). In females, spontaneous, symptomatic and younger patient infections predominated, while in males HAUTI were mostly asymptomatic, after catheterization and in elderly patients. Chronic nonfatal diseases--particularly neurologic disease and diabetes--, old age, previous antibiotic use, the postoperative period, and cancer were the major general predisposing factors, mostly because they involved urological procedures. There was an urethral catheter in 78% of cases, with questionable indication or maintenance in 37%. In 65% of cases there were clinical data attributable to HAUTI; however, on strict criteria only 5% of pyelonephritis and 24% of cystitis were detected. Mortality rate was 0.4%. Etiology was E. coli in 29%, Proteus in 13%, Enterobacter in 12%, enterococcus in 11.5%, Serratia in 7%, Pseudomonas in 6.5%, and Klebsiella in 6.5%. There were differences regarding endogenous and hospital flora on the basis of sex, hospital situation, catheterization, mobility, and previous duration of hospitalization. The microbial resistance pattern was high in the hospital flora. The major therapeutical problem was the high number of unnecessary treatments representing the automatic medical response to the finding of a positive urine culture.
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PMID:[Nosocomially acquired infection of the urinary tract]. 249 Aug 55

Eighty-two evaluable patients suffering from UTI were randomly treated with parenteral Aztreonam (1 g OD in cystitis and 1 g BID in pyelonephritis) or oral Norfloxacin (400 mg BID). Predisposing urological conditions were present in 75% and 78.5% respectively. Microbiological cultures at the end of treatment and at a follow-up visit after 4 weeks showed significantly better results among Aztreonam treated patients (microbiological cure: 97.5% vs 71.4%-p less than or equal to 0.005). Clinical cure was achieved in 97.5% and 71.4% respectively (p less than or equal to 0.001). A statistically significant difference was present only in patients treated for pyelonephritis (microbiological cure-AZT: 100%; NOR: 50%-p less than or equal to 0.0005) and not in those with cystitis (AZT: 95.0%; NOR: 83.3%). Side effects were rare in both treatments. Aztreonam seems to offer major advantages, when compared to Norfloxacin, in the treatment of UTI, especially when upper urinary tract is involved.
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PMID:[Aztreonam vs norfloxacin: a comparative study of the treatment of urinary tract infections in ambulatory and hospitalized patients]. 252 96

Bacteriological, pharmacokinetic and clinical studies on cefpodoxime proxetil (CPDX-PR, CS-807), a new oral cephem antibiotic, were carried out in the field of pediatrics. The results obtained are summarized as follows. 1. Antibacterial activities of R-3746 (Na-salt of cefpodoxime (CPDX] against clinically isolated strains of Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Enterococcus faecalis, Branhamella catarrhalis, Escherichia coli, Proteus mirabilis and Haemophilus influenzae were compared with those of cefaclor, cephalexin and cefadroxil. R-3746 is superior to other antibiotics against S. pneumoniae, S. pyogenes, B. catarrhalis and Gram-negative rods. 2. Serum concentrations of CPDX after administration of CPDX-PR at doses of 3 mg/kg (fasting), 6 mg/kg (non-fasting) and 6 mg/kg (fasting) were determined. Mean AUC (area under curve)'s of CPDX obtained were 9.60, 31.35 and 17.89 micrograms.hr/ml, respectively for the 3 dosages. The mean half-lives of CPDX were 3.35, 1.88 and 1.76 hours, respectively. The mean urinary recovery rate within 8 hours after administration of CPDX-PR at a dose of 3 mg/kg (fasting) was 39.2%. 3. CPDX-PR was administered to 37 pediatric patients with various bacterial infections (pyelonephritis 9, cystitis 4, pneumonia 7, acute bronchitis 3, otitis media 2, tonsillitis 10, subcutaneous abscess 1 and purulent lymphadenitis 1). The overall clinical efficacy rate was 91.9% and the overall bacteriological eradication rate was also 91.9%. 4. No adverse reactions were observed. Abnormal laboratory findings were moderate, eosinophilia in 2 and slight elevation of GOT and GPT in 1. The taste and the odor of the CPDX-PR preparation was sufficiently tolerable. From the above results we have concluded that CPDX-PR is a useful oral antibiotic in the treatment of bacterial infections in children.
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PMID:[Bacteriological, pharmacokinetic and clinical studies on cefpodoxime proxetil in the pediatric field]. 256 89

The pap, prs, pil, and hly operons of the pyelonephritic Escherichia coli isolate J96 code for the expression of P, F, and type 1 adhesins and the production of hemolysin, respectively; the afaI operon of the pyelonephritic E. coli KS52 encodes an X adhesin. Using different segments of these operons as probes, colony hybridizations were performed on 97 E. coli urinary tract and 40 fecal clinical isolates to determine (i) the presence in the infecting bacteria of nucleotide sequences related to virulence operons, and (ii) the phenotypic properties associated with such sequences. Coexpression of P and F adhesins encoded by pap-related sequences was detected more frequently among isolates from patients with pyelonephritis (32 of 49, 65%) than among those with cystitis (11 of 48, 23%; P less than 0.0001) or from fecal specimens (6 of 40, 15%; P less than 0.0001). Therefore, the expression of both adhesins appears to be critical in the colonization of the upper urinary tract. In contrast, afaI-related sequences were detected significantly more frequently among isolates from patients with cystitis, suggesting that this class of X adhesin may have a role in lower urinary tract infections. Urinary tract isolates differed from fecal isolates by a low incidence of type 1 adhesin expression among pil probe-positive isolates. hly-related sequences were only detected in pap probe-positive isolates. The frequency of hemolysin production among pap probe-positive isolates was not associated with a particular pattern of infection. The distribution of these virulence factors was similar in the presence or absence of reflux, indicating that structural abnormalities of the urinary tract did not facilitate colonization by adhesin-negative isolates.
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PMID:Molecular epidemiology of adhesin and hemolysin virulence factors among uropathogenic Escherichia coli. 256 54

The presence of type 1 fimbriae, P fimbriae and X adhesins in 30 strains of Escherichia coli producing pyelonephritis, 30 strains producing cystitis, and 30 strains producing recurrent urinary infections are compared. All the strains were collected from adult women without risk factors for infections of the urinary tract. The presence of P fimbriae was 73% in strains producing pyelonephritis, 40% in strains producing cystitis and 20% in strains producing recurrent urinary infections; the presence of X adhesins was 3%, 0, and 17% respectively. There were, in consequence, significant differences between the groups studied; however, such differences were not observed with respect to the presence of type 1 fimbriae, which was 97%, 97% and 90%, respectively. We conclude that P fimbriae act as a factor of greater virulence in the strains of E. coli producing pyelonephritis and X adhesins are found almost exclusively in the strains producing recurrent urinary infections.
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PMID:[Type 1 fimbriae, P fimbriae and X adhesins in Escherichia strains causing pyelonephritis, cystitis and recurrent urinary infections]. 256 27

Fresh urinary isolates were examined by immunofluorescence with polyclonal rabbit antibodies against type 1 and P fimbriae. This procedure showed P-fimbriate Escherichia coli in 22 of 24 samples from patients with asymptomatic bacteriuria, 24 of 26 samples from patients with cystitis, and 6 of 6 samples from patients with pyelonephritis. Type 1 fimbriae were expressed by less than 40% of isolates in all three groups. There was no relation between the presence of symptoms or the site of infection and fimbrial expression, of P or type 1, by bacteria adherent to freshly isolated uroepithelial cells.
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PMID:Variable expression of P fimbriae in Escherichia coli urinary tract infection. 256 30

A routine urine culture was performed in 1130 normal pregnant women and in 211 high-risk pregnancies (136 diabetics and 75 women with a previous urinary tract infection). Asymptomatic bacteriuria was found in 5.9% of the normal pregnancies, 12.5% among the diabetics and in 18.5% of the previous urinary tract infection patients. The higher incidence of a clinical urinary tract infection among patients with asymptomatic bacteriuria was found statistically significant (p less than 0.001) in all three groups. A high correlation was found between a negative urine culture in early pregnancy and the absence of development of cystitis and pyelonephritis in later pregnancy. The incidence of asymptomatic bacteriuria in normal pregnant women who developed cystitis later in pregnancy was 33.3% and in those developing pyelonephritis, 66%. In the two high-risk pregnancy groups, the incidence of asymptomatic bacteriuria among those developing clinical infection was even higher, 58.3 and 85.7%, respectively, among the diabetics, and 60 and 66.6% respectively, among the previous urinary tract infection patients.
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PMID:Asymptomatic bacteriuria in normal and high-risk pregnancy. 258 35

The authors report very good results of the application of single antibacterial doses in the therapy of acute bacterial cystitis and asymptomatic bacteriuria and point out that in addition to these already established indications, single doses can be applied successfully in some other forms of urinary infection, too. They share the clinical results and on the basis of some experiments maintain the standpoint that postoperative urinary infections are also suitable for this therapy (if no evidence of pyelonephritis is available), as well as the infections of the upper urinary tract (if the isolated microorganisms are not charged with antibodies). A scheme of the so-called "long-term therapy with single dose once a week" is proposed instead of the systematic 3-6 months therapy. The results are compared to the routine 7-10 day course of treatment; as a matter of fact, they are the same. The advantages of the single-dose therapy are discussed.
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PMID:Possibilities of extending the indications for application of single antibacterial doses in urological practice. 261 65

To investigate agreement between physicians about diagnosis and management concepts of genitourinary infection, data from 63 symptomatic women was collected and distributed to a panel consisting of three general practitioners, three urologists and three nephrologists. Using double-blind methods, the panel was asked individually to give a preliminary diagnosis and a management recommendation for each case. Pairwise comparison of the evaluations showed 66% agreement for diagnosis and 79% agreement for prescription of antibiotics. Adjusting for chance agreement, the kappa index was 0.43 for prescription of antibiotics, 0.31 for diagnosis of cystitis, 0.20 for vulvovaginitis, 0.21 for pyelonephritis and 0.09 for urethritis. The specialist groups ordered significantly more laboratory investigations, resulting in a 75-95% more expensive work-up compared with general practitioners. The findings imply a need for more distinct use of the concept of 'urethritis' and are consistent with previously demonstrated differences in resource use between general practitioners and specialist physicians.
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PMID:The semantics of diagnosis and management of genitourinary infections: a cross-specialty study. 263 5

Asymptomatic bacteriuria in pregnant women has been linked to an increased incidence of pyelonephritis, preeclampsia, hypertension, intrauterine growth retardation and premature delivery. Pyelonephritis and cystitis require different antibiotics and dosages in pregnant patients. Renal calculi can be difficult to detect during pregnancy. Women with preexisting renal disease usually do well during pregnancy if renal function is preserved and hypertension is not present.
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PMID:Renal disease and pregnancy. 265 May 4


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