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

11,829 urine cultures, coming from the Pediatrics Department of Florence and other hospital divisions for adults in the period 1st of July-31st of December 1990, have been examined in the Bacteriology and Virology Laboratory of the University Hospital of Florence. Besides illustrating various methods of drawing, preservation and transport of the urinary specimen, the authors showed the incidence of bacterial species responsible of urinary tract infections (U.T.I.). E. coli was showed to be the most frequently isolated bacterial strain, followed by Streptococcus faecalis and Proteus indole negative. The incidence of fimbriated E. coli infections was studied in pediatric and adult patients with urinary tract infections; a higher isolation frequency of fimbriated E. coli was showed in pediatric patients and in these patients the correlation was studied between the presence of fimbriated E. coli and the severity of infection (pyelonephritis, recurrent U.T.I.). The percentages of resistance of the isolated strains against the most common chemotherapies was also showed, studying their variations, for some chemotherapies, during about twenty years.
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PMID:[The microbiological exam of the urine: what significance in urinary tract infections?]. 150 51

The protective effect of immunization with a polyvalent vaccine (SolcoUrovac) was studied in the mouse and the rat. The i.m. immunization increased the resistance of mice to challenge infection with all homologous strains of bacteria. The LD50 values for E. coli, Proteus mirabilis and Streptococcus were 3.5-4.5 times and that of Klebsiella as much as 600 times that in nonimmunized mice. Protection against challenge with heterologous E. coli was also achieved and persisted for about 20 weeks. Immunization with the vaccine also provided marked protection against pyelonephritis in rats. Kidneys with abscesses were seen only one-third as often as in controls, and the size of the individual abscesses was substantially smaller in the vaccinated animals. Based on the quantity of bacteria in the kidneys it was postulated that the vaccination increased the clearance of bacteria.
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PMID:Protection by a polyvalent vaccine against challenge infection and pyelonephritis. 155 95

Cefetamet pivoxil was investigated in an open, randomized comparative study involving a total of 37 children with acute pyelonephritis, whose ages ranged from 2 to 14 years. The patients received either 10 mg/kg (n = 18) or 20 mg/kg (n = 8) cefetamet pivoxil twice daily, or 30-50 mg/kg amoxycillin/clavulanic acid three times daily (n = 11) for a period of 7-10 days. Escherichia coli was the main causative agent isolated in 28 (75.7%) of the patients; other pathogens included Proteus mirabilis (three patients). Proteus species (one patient), Klebsiella pneumoniae (two patients), Pseudomonas diminuta (one patient) and mixed infections (three patients). No differences in the overall treatment outcome could be observed between the treatment regimens used and, at the end of treatment, all pathogens were eradicated with neither relapse, nor persistence of the isolated pathogen, nor reinfection occurring. The clinical signs and symptoms had subsided in all patients at treatment end and the tolerability of the trial drugs was found to be satisfactory with no premature treatment withdrawal required. It is concluded that cefetamet pivoxil in the standard twice-daily dose of 10 mg/kg was equally effective and as well tolerated as 20 mg/kg cefetamet pivoxil given twice daily or 30-50 mg/kg amoxycillin/clavulanic acid given three times daily.
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PMID:Effectiveness of cefetamet pivoxil in the treatment of pyelonephritis in children. 156 23

The authors report on 48 patients with calculous pyelonephritis. Urinary obstruction was caused by renal calculi in 21 patients and ureteral calculi in 27. Urine cultures were positive in 87.5% and bacteremia was seen in 70%. The common organisms in urine and blood culture were E. coli, Proteus and Klebsiella. Septic shock occurred in 10 (20.8%) out of 48 patients. Calculous pyelonephritis with urinary obstruction is a very serious condition.
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PMID:Calculous pyelonephritis. 162 52

Pyelonephritis emphysematous (PE) is a life threatening renal infection which is observed practically exclusively as a serious complication of diabetes mellitus. 95% of the 73 cases which have been reviewed were found in diabetic patients. The symptomatology resembles that of severe acute pyelonephritis but the disease differs from this in that, in PE, emphysema develops in the actual renal parenchyma and/or in the perirenal tissues. The most important single factor in the etiology appears to be ischaemia of the tissues which are employed as growth media for the microorganisms involved. Infections with E. coli, Klebsiella pneumoniae, Aerobacter and Proteus are the most commonly found. Isolated cases with Candida and Cryptococcus neoformans have been observed. The mortality in untreated cases of PE is 100%. With medical treatment alone, the mortality decreases to 73% while, when combined medical and surgical intervention is employed, the mortality can be reduced to 30%.
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PMID:[Emphysematous pyelonephritis. A serious complication of diabetes mellitus]. 163 68

Catheter-associated bacteriuria is the most common infection occurring in hospitals, where urethral catheters are generally in place for a few days, and in nursing homes, where catheters may be in place for months or years. We developed murine models with intrabladder urinary catheters for studying complications of bacteriuria in short- and long-term catheterization. In the short-term model, a catheter segment was inserted transurethrally and lay free within the bladder lumen. Half of the animals expelled segments during a 2-to-7-day period, durations similar to catheterizations in hospitalized patients. For studies of long-term catheter use, the catheter segment was secured within the bladder by a single suture for up to 12 months. Antibiotics administered for 7 days after catheter placement and housing mice in cages with wire screen floors reduced spontaneous bacteriuria to an acceptably low incidence rate of only 7%. Proteus mirabilis bacteriuria of high concentration provoked the same complications that are common in patients with long-term catheters: acute pyelonephritis, chronic renal inflammation, and struvite stone formation. These models allow inoculation of the bacteria of interest and are suitable for studies of short- and long-term foreign body-associated bacteriuria and its complications.
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PMID:Mouse models of short- and long-term foreign body in the urinary bladder: analogies to the bladder segment of urinary catheters. 166 47

Urinary tract infection with Proteus mirabilis may lead to serious complications, including cystitis, acute pyelonephritis, fever, bacteremia, and death. In addition to the production of hemolysin and the enzyme urease, fimbriae and flagellum-mediated motility have been postulated as virulence factors for this species. We purified mannose-resistant/proteuslike (MR/P) fimbriae and flagella from strains CFT322 and HU2450, respectively. Electron microscopy revealed highly concentrated preparations of fimbriae and flagella. Fimbrial and flagellar structural subunits were estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to be 18.5 and 41 kDa, respectively. N-terminal sequencing revealed that 10 of the first 20 amino acids of the major MR/P subunit matched the sequence of the P. mirabilis uroepithelial cell adhesin N terminus and 11 of 20 amino acids matched the predicted amino acid sequence of the Escherichia coli P fimbriae structural subunit, PapA. In addition, 90 and 80% homologies were found between the first 20 amino acids of P. mirabilis flagellin and those of Salmonella typhimurium phase-1 flagellin and the E. coli hag gene product, respectively. An enzyme-linked immunosorbent assay using purified antigens showed a strong reaction between the MR/P fimbriae or flagella and sera of CBA mice challenged transurethrally with P. mirabilis. A possible role for MR/P fimbriae in the pathogenesis of urinary tract infection is supported by (i) a strong immune response to the antigen in experimentally infected animals, (ii) amino acid sequence similarity to other enteric surface structure, and (iii) our previously reported observation that MR/P fimbriae are expressed preferentially as the sole fimbrial type in human pyelonephritis isolates.
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PMID:Proteus mirabilis flagella and MR/P fimbriae: isolation, purification, N-terminal analysis, and serum antibody response following experimental urinary tract infection. 168 Jan 6

A retrospective study of 36 patients with xanthogranulomatous pyelonephritis who underwent nephrectomy at our hospital was performed. The disease occurred most frequently in middle-aged women with a history of recurrent urinary tract disorder. There were 2 cases of focal xanthogranulomatous pyelonephritis, 2 associated with emphysematous pyelonephritis, 2 that manifested as fistula formation between the colon or skin, and 1 with deep sinus formation into the hip joint that presented as septic arthritis. Flank pain and fever were the most frequent complaints. Escherichia coli (67%) and Proteus mirabilis (26%) were the most common organisms isolated from the voided urine, kidney and blood stream. Cephalothin plus gentamicin or tobramycin were the drugs of choice before surgical intervention.
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PMID:Xanthogranulomatous pyelonephritis: experience in 36 cases. 173 87

The authors report about 12 cases of long ureteral calculi, 16 to 39 mm in size, observed over 10 years. They were all made of a mixture of ammonium-magnesium phosphate and calcium phosphocarbonate. Infection was the revealing symptom, either in the form of simple bacteriuria or as acute pyelonephritis or sepsis. These calculi, found in a lumbar or pelvic location, were very long, radiopaque but with a moderate radiological density, homogeneous and have regular contours. They were straight, sometimes slightly bent, rarely (one case out of 12) arciform. In 11 of 12 cases, the affected patient was female. In most cases, the urine was infected by Proteus mirabilis. In spite of their size, the calculi caused total obstruction in 3 of 12 cases only. They were or were not associated to ipsilateral coral calculi of the same chemical type. Destruction was easily achieved with physical agents. The etiological, radiological and therapeutic characteristics of these calculi give them a specific place among ammonium-magnesium phosphate calculi.
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PMID:[Long ureteral ammonium-magnesium phosphate (struvite) and calcium phospho-carbonate calculi]. 180 76

A BALB/c mouse model of nonobstructive, ascending Proteus mirabilis pyelonephritis was characterized bacteriologically, histologically, and serologically from 3 to 28 days. Intravesicular administration of 2 X 10(8) P. mirabilis K7 resulted in the septic death of 9 (16%) of 57 mice by day 15. Among the survivors, K7 colonized the kidneys in great numbers until day 21. Histological examination of the kidneys revealed acute inflammation which was characterized by neutrophil infiltration by day 3, renal necrosis by day 7, and fibroblastic infiltration by day 14 which persisted at least until day 28. The immunoglobulin G response to the outer membrane proteins (OMP) was assessed by enzyme-linked immunosorbent assay and Western blotting (immunoblotting). Anti-OMP immunoglobulin G antibodies were detected as early as day 7, and the reciprocals of their titers rose progressively up to day 28 (i.e., greater than or equal to 500). This model was also used to assess the efficacy of OMP and lipopolysaccharide (LPS) immunization in preventing renal infection. K7 OMP or LPS (100 micrograms) preparations were administered intramuscularly in Freund's complete adjuvant. After 2 weeks, mice were intravesicularly challenged with 2 X 10(8) bacteria of the homologous K7 strain or one of four heterologous strains. Compared with the saline-immunized control group and K7 LPS-immunized mice, K7 OMP recipients were protected from death when challenged by homologous or heterologous strains. In addition, K7 OMP recipients were protected (P less than 0.003) from subsequent renal infection when challenged by the K7 strain and had more rapid bacterial renal clearance when challenged by three of four heterologous strains. OMP recipients produced antibodies which bound major OMP moieties (viz., 36- to 39-kDa cell wall constituents) as assessed by Western blotting. These results support the concept that immunization with selected bacterial protein surface coat constituents can prevent uromucosal infection by interfering with colonization or renal injury.
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PMID:Efficacy of a Proteus mirabilis outer membrane protein vaccine in preventing experimental Proteus pyelonephritis in a BALB/c mouse model. 189 76


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