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

Urinary tract infections (UTIs), according to localization of infection, can be subdivided into urethritis, cystitis, prostatitis and pyelonephritis, according to type of infection into symptomatic, asymptomatic, acute (first or single), recurrent, chronic, complicated and uncomplicated. Clinical symptoms of cystitis and leukocyturia are sufficient reason for early initiation of a three-day empirical antimicrobial therapy of acute uncomplicated cystitis in young women. Urine culture should be performed prior to the initiation of antimicrobial therapy in pregnant women, diabetics, recurrent UTIs, in case of unsuccessful prior treatment and in patients with pyelonephritis. All symptomatic UTIs should be treated, as well as asymptomatic bacteriuria in pregnant women, diabetics, preschool children and prior to urologic-gynecologic surgery. In complicated UTIs it is especially important to determine and try to eliminate or at least put under control the factors that complicate UTIs. Antimicrobial therapy of UTIs includes fluoroquinolones, co-trimoxazole, betalactam antibiotics, aminoglycosides and nitrofurantoin, tetracyclines, macrolides, and azalydes in case of sexually transmitted diseases caused by Chlamydia trachomatis and Ureaplasma urealyticum. Cystitis is treated for 1, 3 or 7 days, asymptomatic bacteriuria 3-7 days, uncomplicated pyelonephritis 10-14 days, bacterial prostatitis 4-8 weeks, and chronic nonbacterial prostatitis 2-4 weeks. Recommended therapy for chronic and complicated UTIs is 7-14 days only in relapses and reinfections, and in some patients it can last for several weeks, up to 6 months. Chemoprophylaxis in recurrent uncomplicated UTIs should be employed for at least 6 months.
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PMID:[Antimicrobial therapy of urinary tract infections]. 1137 93

Species composition and a number of persistence characteristics enterobacteria isolated from urine of 42 pregnant and 22 nonpregnant women with pyelonephritis (relapse, remission), from prostatic fluid of 225 males and secretions of cervical canal of 124 women with urogenital pathology (prostatitis, salpingo-oophoritis) were studied. The study revealed that enterobacteria, including Escherichia coli, prevailed in the structure of uromicroflora (66.7-83.3%) and constituted a relatively small proportion among "genital" isolates of microorganisms (19.9-22.2%). Male and female sterility and the presence of enterobacteria in the reproductive tract of patients were found to be directly correlated. Clinical isolates of enterobacteria were shown to possess pronounced seroresistance and the complex of persistence characteristics, including antilysozyme, anti-intercidal and anticomplementary activity.
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PMID:[Characteristics of enterobacteria isolated from patients with urogenital pathology]. 1156 45

Quinolone-resistant (QR) Escherichia coli may have lower invasive capacity than does quinolone-susceptible E. coli. To evaluate this, we prospectively collected data regarding all cases of E. coli invasive urinary tract infections (IUTI) in 669 adults admitted to the Infectious Diseases Unit of our hospital during a 3-year period, as well as 10,950 patients with cystitis or asymptomatic bacteriuria who presented to the outpatient clinic during a 1-year period. QR E. coli was isolated in 20% of patients with cystitis, compared with 8% of those with IUTI (P<.05). The proportion of E. coli isolates that were quinolone resistant was similar in patients with bacteremic and nonbacteremic IUTI. The factors of urinary manipulation and structural abnormalities were independently associated with the presence of quinolone resistance. Old age was the only variable independently associated with blood invasion. QR E. coli is less likely to produce invasive disease (pyelonephritis and prostatitis) than is quinolone-susceptible E. coli. However, once pyelonephritis or prostatitis have developed, there is no difference in the incidence of bacteremia.
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PMID:Decreased invasive capacity of quinolone-resistant Escherichia coli in patients with urinary tract infections. 1159 90

The aim of imaging in urinary tract infection is to detect conditions that must be treated in order to avoid immediate deterioration or recurrences, and probable long-term kidney damage. In newborns identified with hydronephrosis during pregnancy or by neonatal screening, vesicoureteral reflux and renal scarring are congenital and not caused by infection. Most of these patients are male and the vesicoureteral reflux is of a higher grade than that detected in girls having had urinary tract infection. In children with urinary tract infection, several authors advocate a more selective policy and recommend imaging only in those children who are at risk for developing renal damage. In adult females no imaging is necessary in cystitis, whereas ultrasonography and plain films are recommended in acute pyelonephritis. Because uncomplicated urinary tract infection in men is rare, diagnostic evaluation including imaging should be started early in order to rule out complicating factors within the urinary tract. The role of imaging in prostatitis, vesiculitis, epididymitis and orchitis is primarily to rule out abscess formation, but also to exclude testicular malignancies.
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PMID:Diagnosis and imaging in urinary tract infections. 1175 32

The treatment of urinary tract infections (UTIs) and prostatitis has to be tailored on the clinical features of patients. UTIs should be differentiated in uncomplicated UTIs, acute pyelonephritis, complicated UTIs and UTIs in men, and asymptomatic UTIs. Prostatic inflammatory disease can be divided in 5 categories. Uncomplicated UTIs should be treated with a 3-day course of oral antibiotics, pyelonephritis and complicated UTIs with a 14-day course of oral antibiotics. In the case of high fever with chills intensive treatment with an appropriate antibiotic administered intravenously is needed until subsidence of the acute symptoms. This should be followed by oral antibiotic for two weeks. The treatment of asymptomatic UTIs should be considered for children and pregnant women. Antibiotics should be administered for 14-42 days in category I to IIIA of inflammatory prostatic disease. In the last decade acquired resistance of uropathogens to aminopenicillins and trimethoprim-sulfamethoxazole appears to have been increasing in the United States and Europe, while the susceptibility to systemic fluoroquinolones has remained unchanged at 98-99%. Particularly levofloxacin showed activity against Gram-positive bacteria without loss of Gram-negative spectrum. In normal adults levofloxacin reached urinary, bladder and prostate concentrations after a 250 mg oral dose above the MIC90 for all typical uropathogens. Multicenter clinical studies on clinical and microbiological efficacy of levofloxacin were carried out in the treatment of genitourinary tract infections. Levofloxacin 250 mg once daily for three days was highly effective in the treatment of uncomplicated UTIs. Levofloxacin 250 mg once daily for 7-10 days was clinically and microbiologically effective also for the treatment of acute pyelonephritis and complicated UTIs. In patients with nonchlamydial chronic prostatitis the bacteriological response was 85.4%. Finally levofloxacin showed a superior tolerability profile than other fluoroquinolones.
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PMID:[Role of levofloxacin in the treatment of urinary tract infections]. 1175 33

Lomefloxacin, as other fluoroquinolones, is a drug of choice in the treatment of uncomplicated urinary infections (acute cystitis, pyclonephritis) in outpatient practice. The advantage of lomefloxacin consists in a single-dose regimen (400 mg with 24-h interval). A course of acute cystitis lasts 3 days, acute pyelonephritis--10-14 days. Lomefloxacin is also the first-line drug in exacerbation of mild or moderate chronic pyclonephritis in hospitals and outpatient clinics. Fluoroquinolones are now most effective in management of acute or exacerbation of chronic bacterial prostatitis. Optimal lomefloxacin regimen in prostatitis is 400 mg with 24-h interval for one month. For prevention of postoperative suppuration in prostatic resection lomefloxacin is given in a single dose 400 mg 3-6 hours prior to operation. If operation is to be performed in the presence of urinary infection or prostatitis, lomefloxacin should be taken for 5-7 days before surgery.
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PMID:[Lemofloxacin: antimicrobial ability and clinico-pharmacokinetic basis for use in urogenital infections]. 1187 63

A novel difluoroquinolone drug sparfloxacine has a wide antibacterial spectrum. It is active both against gram-negative and gram-positive flora. Sparfloxacine was tried in 43 patients with pyelonephritis and prostatitis complicated with urolithiasis, diabetes mellitus, nephroptosis, anomalous kidneys, etc. The drug was given according to its pharmacokinetics for 7-14 days in a daily dose 400 mg (day 1) then 200 mg/day. The effectiveness of sparfloxacine in complicated pyelonephritis and prostatitis was rather high: clinical response reached 83.7%, bacteriological one--78.7%.
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PMID:[Effectiveness of sparfloxacin (sparflo) in the treatment of complicated forms of pyelonephritis and prostatitis]. 1189 27

The authors review the effectiveness of a novel fluoroquinolone drug sparfloxacine (Sparflo, Dr. Reddy's Laboratories) in the treatment of patients with complicated forms of pyelonephritis and prostatitis. Both gramnegative and grampositive agents causing complicated urologic infections were highly sensitive to sparfloxacine: Enterobacter spp.--40.8%, Pseudomonas aeruginosa--38.5%, Proteus spp.--42.6%, E. coli--91.4%, Staphylococcus spp.--80.0%, Enterococcus faecalis--21.4%. Sparfloxacine was used in the treatment of 43 patients with complicated pyelonephritis and prostatitis. The complicating factors were the following: urolithiasis, renal anomalies, hydronephrotic transformation, nephroptosis, benign prostatic hyperplasia. Clinical response reached 83.7%; microbiological--78.7%. Thus, sparfloxacin has a wide spectrum of antibacterial activity and can be effectively used in patients with complicated infections of the urinary tract.
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PMID:[Use of sparfloxacin (Sparflo) in treating complicated urologic infections]. 1207 17

Sparfloxacin efficacy evaluation for the treatment of urogenital tract infections is presented. The trial was performed on 43 patients with chronic complicated infections of urogenital tract (pyelonephritis, prostatitis). Sparfloxacin (once daily for 7-14 days) was highly effective in the infection management according to clinical and bacteriological results (83.7 per cent and 78.1 per cent subsequently).
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PMID:[Sparfloxacin (Sparflo) in the treatment of urological infections]. 1207 35

Differences in the presence of nine urovirulence factors among clinical isolates of Escherichia coli causing cystitis and pyelonephritis in women and prostatitis in men have been studied. Hemolysin and necrotizing factor type 1 occur significantly more frequently among isolates causing prostatitis than among those causing cystitis (P < 0.0001) or pyelonephritis (P < 0.005). Moreover, the papGIII gene occurred more frequently in E. coli isolates associated with prostatitis (27%) than in those associated with pyelonephritis (9%) (P < 0.05). Genes encoding aerobactin and PapC occurred significantly less frequently in isolates causing cystitis than in those causing prostatitis (P < 0.01 and P < 0.0001, respectively) and pyelonephritis (P < 0.01 and P < 0.0001, respectively). No differences in the presence of Sat or type 1 fimbriae were found. Finally, AAFII and Bfp fimbriae are no longer considered uropathogenic virulence factors since they were not found in any of the strains analyzed. Overall, the results showed that clinical isolates producing prostatitis need greater virulence than isolates producing pyelonephritis in women or, in particular, cystitis in women (P < 0.05). Overall, the results suggest that clinical isolates producing prostatitis are more virulent that those producing pyelonephritis or cystitis in women.
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PMID:Differences in virulence factors among clinical isolates of Escherichia coli causing cystitis and pyelonephritis in women and prostatitis in men. 1245 34


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