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)

Infection of the urinary tract in childhood is common. It may start already in neonates or infants. Clinical signs are not always present but asymptomatic socalled bacteriuria may occur at any age. The earlier a child contracts the infection the more common are uncharacteristic clinical signs like loss of appetite, a raised temperature, parenchymatous icterus and, finally signs of involvement of the central nervous system. During the last few years purposeful research has established the important fact that, if there has been a urinary tract infection particularly in the first months of life, recurrence may more often be asymptomatic than on the first occasion. A mid-stream specimen is diagnostically valuable. If this does contain any bacteria, then supapubic aspiration from the bladder is useful in enabling us to start a specific, if possible bactericidal, therapy. Asymptomatic bacteriuria may at any time lead to clinical signs of pyelonephritis, particularly during periods of stress. Such silent unrecognized cases of asymptomatic bacteriuria may, we feel, lead to pyelonephritic nephrosis in a so far unknown percentage of cases.
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PMID:[Recurrent urinary tract infection in childhood. Diagnosis, treatment, prognosis (author's transl)]. 116 77

Bacteriuria is much more common among elderly than among younger populations, and is most often asymptomatic. Asymptomatic bacteriuria in the elderly is a benign condition in the vast majority of cases and does not require therapy. When symptomatic lower UTI occurs, short-course (3-day) therapy with any of several agents is indicated, and is usually effective. Women with frequently recurrent symptomatic UTI may benefit from estrogen therapy. Fourteen days of therapy is indicated in patients with upper UTI. The typical signs and symptoms of pyelonephritis may be altered or absent in elderly patients.
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PMID:Special problems of urinary tract infection in the elderly. 199 40

Pregnancy induces anatomical and physiological changes in the urinary tract. In this condition a bacteriuria, even asymptomatic, may lead more frequently to pyelonephritis. Asymptomatic bacteriuria in pregnant women has therefore got to be treated. According to recent studies, long course antibiotherapy did not prove to be more effective than a single-dose one in the case of non-complicated bacteriuria. Moreover, the maternal and foetal toxicity should be reduced in the latter regimen. In this paper we present the preliminary results of our study comparing a single-dose treatment by fosfomycin trometamol (3 g) and nitrofurantoin (200 mg per day during a week).
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PMID:Single dose fosfomycin trometamol versus multiple dose nitrofurantoin in pregnant women with bacteriuria: preliminary results. 228 69

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 genito-urinary tract is the most frequent site of infection during pregnancy. Asymptomatic bacteriuria is found in 2 to 12% of the obstetrical population. The importance of its detection is underlined by the fact that 20 to 40% of untreated cases will present acute pyelonephritis. Our study's first aim was determining the incidence of asymptomatic bacteriuria in our population. Our results show an incidence of 3.9%. Second, routine mandatory prenatal laboratory examinations include urinalysis and urine culture. Considering the fact that we already do a routine culture, we questioned the pertinence of the microscopic part of urinalysis for screening asymptomatic bacteriuria. Our study has shown that no amount of erythrocytes, leucocytes, bacteria, pus or combination thereof has sufficient sensitivity and/or specificity to be used for screening. We thus conclude that in our context of budget restrictions, the microscopic analysis of urine should be abandoned as a routine test. The biochemical part of urinalysis could be done easily with dipsticks at a lower cost. Urine culture remains the gold standard for detection of asymptomatic bacteriuria.
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PMID:[The pertinence of microscopic analysis of the urine as a diagnostic test for asymptomatic bacteriuria in pregnancy]. 260 50

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

We used immunoblotting to examine the serologic antibody responses to outer membrane proteins (OMP) of Escherichia coli in both symptomatic and asymptomatic elderly subjects with urinary tract infections. Controls with no present or past urinary tract infections showed variable weak immunoglobulin G (IgG) antibodies to OMP of infecting strains. Elderly individuals with asymptomatic infections demonstrated antibody to both lipopolysaccharide (LPS) and OMP of their infecting strain, with consistent cross-reactivity to OMP of other infecting strains. Young females with acute pyelonephritis showed an IgG response to LPS and OMP with cross-reactivity to OMP of other strains. Elderly individuals with symptomatic invasive infections had strong reactions to both LPS and OMP in specimens collected during the acute phase, generally with an increase in intensity in specimens from convalescent patients. They also demonstrated extensive cross-reactivity to LPS and OMP from all other infecting strains. IgM antibody was not observed in any patients. These data confirm other reports of low levels of antibodies to OMP of E. coli in normal populations. Asymptomatic bacteriuria in this population is associated with antibody responses to the LPS and OMP of the infecting strain. Elderly individuals with invasive infections had initial reactions to the infecting strain with an apparent increase in intensity during convalescence. Antibodies to the major OMP appear to be broadly cross-reactive.
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PMID:Immunoblot analysis of serologic response to outer membrane proteins of Escherichia coli in elderly individuals with urinary tract infections. 305 63

Asymptomatic bacteriuria in pregnant women shall always be treated, because of the risk of development of acute pyelonephritis. Some antibiotics reduce the level of serum estriol and therefore are less suitable in the treatment of cystitis in the last trimester of pregnancy. Mecillinam is found effective against the most frequent urinary pathogen in cystitis in pregnancy (escherichia coli), and as it is found not to reduce the level of serum estriol it is concluded that pivmecillinam/mecillinam is an alternative in the treatment of symptomatic and asymptomatic urinary tract infections in the last trimester of pregnancy.
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PMID:Serum estriol level during treatment with pivmecillinam. 630 83

Urinary tract infections (UTIs) are still one of the most common bacterial infections in pregnant and non-pregnant women. It is estimated that about 10-20% of all women suffer from a UTI at some point in life. The presence of UTI is defined as the existence of urinary symptoms such as frequency of urination and dysuria with or without bacteriuria or pyuria. The prevalence of bacteriuria in females varies from less than 1% in infants to 10% and more in older women. There are major differences in the clinical features between young and elderly women depending on the different pathogenesis, microbiology and general condition. Especially for elderly women, symptomatic and asymptomatic bacteriuria presents a risk factor for bacteraemia, sepsis and also increased mortality. During pregnancy, the prevalence of bacteriuria does not change but there are some changes in the pathogenesis that increase the rate of pyelonephritis. Asymptomatic bacteriuria rarely resolves spontaneously during this time. For non-pregnant women, short therapy strategies are recommended, preferably 3 days of trimethoprim-sulphamethoxazole (TMP/SMX) or quinolones. In pregnant women, therapy with amoxycillin or an oral cephalosporin is considered optimal.
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PMID:Uncomplicated urinary tract infections in pregnant and non-pregnant women. 840 50

Asymptomatic bacteriuria occurs in 4 to 7 percent of pregnancies and is associated with the development of acute pyelonephritis, preterm labor and low-birth-weight infants. Treatment of bacteriuria prevents up to 80 percent of cases of pyelonephritis and reduces the risk of preterm delivery. All women should be screened for bacteriuria by a urine culture at the first prenatal visit. Women with bacteriuria should be treated with appropriate antibiotics and should be monitored throughout pregnancy to identify recurrences. Women with persistent bacteriuria require antibiotic suppression until delivery and urologic evaluation following delivery. Urologic evaluation during pregnancy is indicated if bacteriuria persists despite antibiotic therapy.
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PMID:Asymptomatic bacteriuria in pregnancy. 846 18


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