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

The relationship between bacterial characteristics and the severity of urinary tract infection in adults has not been clarified. In this study, Escherichia coli strains (n = 178) were prospectively collected from women with community-acquired urinary tract infection. The isolates were identified by O:K:H serotype and characterized for adherence, hemolysin production, and serum bactericidal resistance. The patients had acute pyelonephritis with or without complicating factors and acute cystitis. Nine serotypes (O1:K1:H7, O1:K1:H-, O2:K1:H-, O4:K12:H1, O7:K1:H-, O9:K34:H-, O16:K1:H6, O16:K1:H-, and O75:K5:H-) comprised 65% of the strains in uncomplicated pyelonephritis, but were significantly less often encountered in complicated pyelonephritis or cystitis. Adherence was the single property most characteristic of the pyelonephritogenic clones. Adhesins specifically recognizing Gal alpha 1----4Gal beta-containing receptors occurred in 80% of strains in uncomplicated pyelonephritis, in 50% of strains in complicated infections, and in 37% of cystitis strains. Hemolysin production and serum resistance did not correlate with any disease pattern. Advanced age did not seem to reduce the selection of virulent E. coli to cause pyelonephritis. These results demonstrate in women a relationship between E. coli virulence and the severity of urinary tract infection analogous to that previously observed in pediatric populations and also illustrate the balance between host resistance and bacterial virulence in the urinary tract.
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PMID:Virulence of Escherichia coli in relation to host factors in women with symptomatic urinary tract infection. 304 54

The aim of the present study was to investigate the effects of sub-MIC doses of oxolinic acid (quinolone), widely used in the treatment of urinary tract infections, on both haemagglutinating activity and adhesion capacity of 13 Escherichia coli strains isolated from urine during acute cystitis or pyelonephritis. All these strains adhered to uroepithelial cells and showed mannose-sensitive and/or mannose-resistant haemagglutinating activity. Sub-MIC doses of oxolinic acid induced filaments in most of the bacterial cultures; however, inhibition of haemagglutination and adhesion was variable in vitro. When inhibition did take place in any one strain, both haemagglutination and adhesion were affected. These results confirm those of other authors and indicate that the effect of sub-MIC doses of a given antibiotic is strain-specific; they also indirectly show the heterogeneity of E. coli strains isolated from urine. It thus seems unlikely that, in clinical conditions, a single antibiotic is capable of reducing adhesion, given the diversity of the adhesins found in pathogenic E. coli strains.
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PMID:[In vitro study of the effects of oxolinic acid at sub-inhibitory concentrations on the activity of hemagglutinins and adhesion to uroepithelial cells by Escherichia coli isolated from urine]. 330 60

Urinary infections, with a spectrum from covert bacteriuria to severe pyelonephritis, commonly complicate pregnancy. Serious infections follow untreated silent bacteriuria in a fourth of cases, and routine screening can be justified in high-risk populations, particularly those from lower socioeconomic strata. Despite an initial salutary response to a number of antimicrobial regimens, covert bacteriuria recurs in one-third of treated women whose risk of pyelonephritis remains at 25%. Acute cystitis may be unrelated to these other infections and responds readily to a number of regimens; however, single-dose therapy is not recommended since early pyelonephritis can be mistaken for uncomplicated cystitis. Pyelonephritis is the most common severe bacterial infection complicating pregnancy. These women are frequently quite ill, and hospitalization is recommended. Since 85% to 90% respond within 48 hours to intravenous fluids and antimicrobials, continued fever and evidence of sepsis after two or three days should prompt a search for underlying obstruction. Perhaps 20% of women with severe pyelonephritis develop complications that include septic shock syndrome or its presumed variants. These latter include renal dysfunction, haemolysis and thrombocytopaenia, and pulmonary capillary injury. In most of these women, continued fluid and antimicrobial therapy result in a salutary outcome, but there is occasional maternal mortality.
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PMID:Urinary tract infections complicating pregnancy. 333 Apr 91

The usefulness of measuring serum antibodies to Tamm-Horsfall protein (THP) for diagnosing the level of acute urinary tract infections in adult women was evaluated. There was a significant (p less than 0.001) elevation of IgG and IgA anti-THP in pregnant and non-pregnant women with acute pyelonephritis compared to women with acute cystitis. The changes in anti-THP antibody titre among patients with acute pyelonephritis varied considerably, limiting the value of determining such antibodies for diagnostic purposes. Patients with febrile infections of non-renal origin demonstrated an antibody response comparable to the pyelonephritis patients. One explanation for these results could be that fever is associated with transient rental tubular damage, thus exposing THP to the immune system. Polyclonal antibody activation seems less likely since neither an IgM antibody response to THP, nor an increase in antibody titre to poliovirus could be demonstrated.
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PMID:Association between fever and the antibody response to Tamm-Horsfall protein in urinary tract infection. 344 27

We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted antibody-coated bacteria test results from negative to positive after therapy. We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy.
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PMID:Single-dose therapy for cystitis in women. A comparison of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin. 387 Dec 33

A group of 27 female and 2 male urological patients, aged 19 to 80 years (mean 44 years), were treated with intravenous temocillin 500 mg twice daily for 5 to 7 days. The diagnoses were acute pyelonephritis (n = 20), acute cystitis (n = 6), and acute cystitis and pyelonephritis combined (3). The causative organisms were Escherichia coli (n = 20). Proteus species (n = 9). Klebsiella species (n = 4). Streptococcus faecalis (n = 2). Staphylococcus epidermidis (n = 1), and Providencia stuartii (n = 1). 27 of the 29 patients (93%) were clinically and bacteriologically cured; bacteriuria persisted in 2 patients with prolonged obstructive uropathy. In acute non-obstructive pyelonephritis, the urinary excretion of beta-2-microglobulin rapidly decreased, documenting a prompt renal tubular restitution during therapy. The drug was well tolerated and proved very safe with regard to haematological, hepatic and renal parameters. Also, Candida haemagglutination titres did not increase significantly during therapy. Temocillin therapy should preferably be commenced after the results of the urine culture are available.
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PMID:Clinical evaluation of temocillin in urinary tract infections. 389 36

Escherichia coli strains isolated from three groups of patients with urinary tract infections, such as acute pyelonephritis, acute cystitis, and asymptomatic bacteriuria, were analyzed with respect to their physicochemical surface properties by means of polymer two-phase partitioning in dextran-polyethylene glycol systems and hydrophobic interaction chromatography on Octyl-Sepharose. Strains causing acute pyelonephritis constituted a homogenous group which, depending on the growth conditions, demonstrated smooth-type lipopolysaccharide, elevated negative charge, and liability to hydrophobic interaction, whereas strains isolated from acute cystitis and asymptomatic bacteriuria showed a more heterogenous pattern.
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PMID:Physicochemical surface properties of Escherichia coli strains isolated from different types of urinary tract infections. 611 38

Hemophilus influenzae has rarely been reported to cause urinary tract infections, but media supportive of its growth are not routinely used for urine cultures. At two Veterans Administration medical centers, H influenzae was isolated from the urine of eight men in the past four years. All had anatomic or functional genitourinary abnormalities, and half had had chronic pyelonephritis or recurrent urinary tract infections. Three patients had acute cystitis, two patients had pyelonephritis, two patients had prostatitis, and one patient had asymptomatic bacteriuria with pyuria. Cases were discovered by primary isolation on chocolate agar or sheep's blood agar, by "satelliting" around staphylococci, or by positive urine Gram's stains. Urine Gram's stains disclosed organisms in all six nonprostatitis cases. Organisms were all nonserotypable, were of biotypes 2, 3, or 4, and were beta-lactamase negative. Hemophilus influenzae may be a more common uropathogen in adults than previously recognized.
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PMID:Hemophilus influenzae as a cause of urinary tract infections in men. 633 7

Urinary tract infection is one of the most common medical complications of pregnancy, occurring in roughly 10% of all pregnancies. The clinical entities most commonly seen are bacteriuria, acute cystitis, and acute pyelonephritis. Relative stasis of urine due to pregnancy-induced changes in the urinary tract is a significant causative factor. Escherichia coli is the most common responsible organism. Patients with untreated or inadequately treated asymptomatic bacteriuria are at high risk for development of acute pyelonephritis, a serious febrile illness that can lead to major maternal and fetal complications. Patients with acute pyelonephritis should be hospitalized and treated aggressively.
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PMID:Urinary tract infection during pregnancy. Asymptomatic bacteriuria, acute cystitis, and acute pyelonephritis. 637 41

More attention should be directed to upper urinary tract infections as they cause renal parenchymal damage. Recently, many reports on antibody-coated bacteria (ACB) in urological diseases have been made. We performed ACB tests in 68 cases of urological infectious diseases. The tests were made according to Thomas' method. Anti-human immunoglobulin IgG, IgA, and IgM rabbit sera were used. The results were compared using the chi-square analysis. ACB-positive were 0 approximately 15% of the cases of acute cystitis, 33 approximately 67% of the cases of chronic cystitis, 30 approximately 60% of the cases of prostatitis and urethritis, and 60 approximately 90% of the cases of pyelonephritis. The percentage was higher in the patients who had indwelling catheters than in those who did not. The ACB test was suggested to be helpful in diagnosing upper urinary tract infection in the female patients who did not have indwelling catheters. But there was the danger of making an incorrect diagnosis with this test on male patients who had indwelling catheters, and those with prostatitis or urethritis, and on female patients with indwelling catheters.
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PMID:[Urinary tract infection : clinical significance of antibody-coated bacteria]. 638 63


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