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)

Unasyn is a combination of ampicillin, a bactericidal antibiotic, and sulbactam, an inhibitor of beta-lactamases. It was used in treatment of 36 patients with urogenital infections. The combination was administered intravenously and in the main intramuscularly. The treatment course amounted to 7-10 days. The average daily dose was 6 to 9 g. 22 patients with acute nonocclusive pyelonephritis were treated with the combination and its clinical and bacteriological efficacy was stated in 95 per cent of the cases. An excellent clinical effect of the combination was observed in 6 patients with acute epididymitis. A clinical improvement was also observed in the treatment of the patients with acute prostatitis and chronic renal infections. Unasyn proved to be a highly efficient antibacterial combination with regard to gram-positive flora and colon bacilli as representatives of gram-negative organisms. Satisfactory results were also stated in the treatment of infections caused by Proteus spp. Complete elimination of the pathogen was achieved in 57.7 per cent of the cases. No adverse reactions to Unasyn except pain in the site of the injection were recorded.
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PMID:[The use of ampicillin/sulbactam (Unasyn) in treating inflammatory urological diseases]. 189 84

The paper reports on a case of chronic pyelonephritis with bacillus Proteus, generated by an intravesical foreign body (sewing needle). The needle was extracted with surgical cystoscope. After removing the foreign body, nalidixic acid was administered. The immediate evolution of the case was good.
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PMID:[An intravesical foreign body--the cause of chronic pyelonephritis in a child]. 196 14

Experimental materials on choosing antibiotics for etiotropic therapy of opportunistic infections with an account of the regulating effect of the drugs on the ++anti-lysozyme activity of pathogens (the factor of intracellular parasitism) are presented. The in vitro data were applied to the clinical trials in 30 patients with chronic and acute pyelonephritis of the Proteus etiology and to 25 patients with chronic inflammatory diseases of Staphylococcus etiology. It was shown that the use of the antibiotics which lowered the ++anti-lysozyme activity of microorganisms promoted a more rapid disappearance of the disease clinical signs, increased 2- to 3-fold the terms of the remission and resulted in an increase in the number of the persons with complete remission (54.5 to 63.6 per cent) as compared to the use of the drugs which stimulated the pathogen property or were indifferent to it.
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PMID:[Experimental and clinical studies of drug regulation of the anti-lysozyme activity of microorganisms causing opportunistic infections]. 202 9

Proteus mirabilis, a common agent of nosocomially acquired and catheter-associated bacteriuria, can cause acute pyelonephritis. In ascending infections, bacteria colonize the bladder and ascend the ureters to the proximal tubules of the kidney. We postulate that Proteus species uses the HpmA hemolysin and urease to elicit tissue damage that allows entry of these bacteria into the kidney. To study this interaction, strains of Proteus mirabilis and P. vulgaris and their isogenic hemolysin-negative (hpmA) or isogenic urease-negative (ureC) constructs were overlaid onto cultures of human renal proximal tubular epithelial cells (HRPTEC) isolated from kidneys obtained by immediate autopsy. Cytotoxicity was measured by release of soluble lactate dehydrogenase (LDH). Two strains of P. mirabilis inoculated at 10(6) CFU caused a release of 80% of total LDH after 6 h, whereas pyelonephritogenic hemolytic Escherichia coli CFT073 released only 25% at 6 h (P less than 0.012). Ten P. mirabilis isolates and five P. vulgaris isolates were all hemolytic and cytotoxic and produced urease which was induced by urea. The HpmA hemolysin is apparently responsible for the majority of cytotoxicity in vitro since the hemolysin-negative (hpmA) mutants of P. mirabilis and P. vulgaris were significantly less cytotoxic than wild-type strains. P. mirabilis WPM111 (hemolysin negative) was used to test the effect of urease-catalyzed urea hydrolysis on HRPTEC viability. In the presence of 50 mM urea, WPM111 caused the release of 42% of LDH versus 1% at 6 h in the absence of substrate (P = 0.003). We conclude that the HpmA hemolysin of Proteus species acts as a potent cytotoxin against HRPTEC. In addition, urease apparently contributes to this process when substrate urea is available.
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PMID:Cytotoxicity of the HpmA hemolysin and urease of Proteus mirabilis and Proteus vulgaris against cultured human renal proximal tubular epithelial cells. 203 63

The efficacy and tolerance of cefodizime in the treatment of acute pyelonephritis were evaluated in an open, international, multicentre study. In total, 128 patients were treated with 1 g cefodizime bd iv or im for a mean of 8.3 days. Underlying urinary tract abnormalities were present in 35% of cases. The most frequently isolated bacteria were Escherichia coli (79/97 evaluable cases) and Proteus mirabilis (8/97 evaluable cases). The overall clinical and bacteriological success rate was 89.7% (87/97). The drug was well tolerated, with only a few mild and transitory adverse events. Tolerance at the site of injection was good in 97.5% (78/80) of those treated iv, and 79% (38/48) of those treated im. Three patients had skin reactions which were probably related to cefodizime. Alterations of laboratory parameters were seen transiently in five patients (3.9%). Cefodizime is effective and well tolerated in the treatment of acute pyelonephritis.
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PMID:Efficacy and tolerance of cefodizime in the treatment of acute pyelonephritis. 207 45

We are reporting 2 cases of xanthogranulomatous pyelonephritis in boys of 7 and 2 year-old. The inflammatory lesion had extended to perirenal tissues and appeared as a lumbar abscess in case 1. The kidneys affected were diffusely compromised by the lesion. Both cases showed Proteus mirabilis after microbiologic cultures. Definitive diagnosis was done by pathology examination. Nephrectomy was curative.
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PMID:[Xanthogranulomatous pyelonephritis in infancy and childhood. Report of two cases]. 207

In a prospective, open clinical study, 50 urological patients with acute pyelonephritis were treated with the oral cephalosporin cefixime. The medication (2 x 200 mg/day) was given for seven to ten days. Clinical, bacteriological as well as hematological examinations were carried out prior to, during and immediately after therapy. A late check-up was performed five to nine days after the end of therapy. 46 of the 50 cases were evaluable for efficacy, and all 50 patients were included in safety evaluation. The most frequent pathogens isolated prior to therapy were Escherichia coli (34 times), Proteus mirabilis (six times), Klebsiella pneumoniae (twice) and coagulase-negative staphylococci (twice). Immediately after the end of therapy the pathogens were eradicated in 44 (97.5%) patients. At the late check-up the urine was sterile in 29 (63%) patients. A relapse was observed in 11 patients, a reinfection in four and the initially isolated pathogens had persisted in two. Immediately after the end of therapy 44 (95.7%) patients were clinically cured and two patients had improved. At the late check-up 41 patients were classified as clinically cured, three showed improvement, and two improvement with relapse. Adverse reactions (one case nausea and exanthem, and one case of meteorism) occurred in two patients. No changes in the blood counts or in the liver and kidney functions were observed. In the study described here cefixime proved to be an effective and well tolerated antibiotic for the treatment of upper urinary tract infections; it is of particular interest that 16 of the 50 patients presented with underlying disease favoring infection.
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PMID:[Effectiveness and tolerance of cefixime in the treatment of acute pyelonephritis]. 207 74

Etiopathogenesis of inflammatory processes of the urinary tract, mainly of obstructive uropathy and chronic pyelonephritis, is reviewed. The most frequent cause of obstruction is renal calculosis; in the pathogenesis of chronic pyelonephritis the following factors are of great importance: renal and urethral anomalies, renal stones, pregnancy, bladder instrumentation as catheterisation, etc. We analyzed 2101 random by selected hospital patients and found significant bacteriuria in 740 (35 p.c.) of them. The most frequent cultured bacteria which caused urinary infection were: Proteus strains (29.3 p.c), E. coli (27.5 p.c.) and Pseudomonas aerug. (13,6 p.c.) Significant bacteriuria was more frequent in men than in women, but E. coli was more frequent in women (71.5 p.c.). Proteus, Pseudomonas and Klebsiella were more frequent in men. It should be noted that the majority of patients with positive urinary cultures were subjects treated at the Urology Department; and that men prevailed. This is the reason why our results related to the causing bacteria differed from those found in general population.
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PMID:[Etiopathogenesis of the inflammation process and the incidence of urinary tract infections]. 210 60

Proteus mirabilis, a common cause of urinary tract infection, can lead to serious complications including pyelonephritis. Adherence factors, urease, and hemolysin may be virulence determinants. These factors were compared for bacteria cultured from 16 patients with acute pyelonephritis and 35 with catheter-associated bacteriuria and for 20 fecal isolates. Pyelonephritis isolates were more likely (P less than .05) to express the mannose-resistant/Proteus-like (MR/P) hemagglutinin in the absence of mannose-resistant/Klebsiella-like (MR/K) hemagglutinin than were catheter-associated or fecal isolates. Pyelonephritis isolates produced urease activity of 63 +/- 27 (mean +/- SD) mumol of NH3/min/mg of protein, not significantly different from catheter-associated or fecal isolates. Hybridization of Southern blots of P. mirabilis chromosomal DNA with two urease gene probes demonstrated that urease gene sequences were conserved in all isolates. Geometric mean of reciprocal hemolytic titers for pyelonephritis isolates was 27.9; for urinary catheter isolates, 18.0; and for fecal isolates, 55.7 (not significantly different, P greater than .1). Although in vivo expression of urease and hemolysin may not be reliable indexes of virulence, MR/P hemagglutination in the absence of MR/K hemagglutination may be necessary for development of pyelonephritis.
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PMID:Hemagglutinin, urease, and hemolysin production by Proteus mirabilis from clinical sources. 217 24

Fifty-five adult patients with acute uncomplicated pyelonephritis were investigated in an open, prospective, randomized comparative study in which 31 patients were allocated to receive 1000 mg cefetamet pivoxil twice daily (or 2000 mg once daily) and 24 to receive 1000 mg cefadroxil twice daily, given orally for 10 to 15 days. Both groups were comparable for age, sex and body weight. Clinical signs and symptoms, i.e. flank tenderness, dysuria, urgency and pyuria, subsided somewhat more rapidly with cefetamet pivoxil, while defervescence was obtained by Day 3 +/- 1 in both groups. Twenty-nine of the cefetamet pivoxil patients were assessed bacteriologically. The pathogens isolated prior to treatment were E. coli (22), Proteus mirabilis (5), P. vulgaris (1) and P. stuartii (1). All 29 patients had sterile urine at treatment end. In the 22 assessable patients in the cefadroxil group, the pathogens isolated before treatment were E. coli (17), P. mirabilis (3), and K. pneumoniae (2). Six patients had relapsed at treatment end (5 E. coli and 1 P. mirabilis). Patients were re-assessed at follow-up, usually 2 to 4 weeks after the end of treatment. Four of the 29 patients in the cefetamet pivoxil group showed relapse (3 E. coli and 1 P. mirabilis) as did a further 3 in the cefadroxil group (2 E. coli and 1 P. mirabilis). The overall therapeutic outcome was considered as successful, i.e. cure or improvement, in 89.7% of the cefetamet pivoxil patients and 72.7% of those who had received cefadroxil. Tolerability was satisfactory for both trial drugs and there were only a few mild to moderately severe adverse events reported.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cefetamet pivoxil in acute pyelonephritis: an open study. 218 96


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