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)

We have derived and characterized a highly pathogenic molecular isolate of feline immunodeficiency virus subtype C (FIV-C) CABCpady00C. Clone FIV-C36 was obtained by lambda cloning from cats that developed severe immunodeficiency disease when infected with CABCpady00C (Abbotsford, British Columbia, Canada). Clone FIV-C36 Env is 96% identical to the noninfectious FIV-C isolate sequence deposited in GenBank (FIV-Cgb; GenBank accession number AF474246) (A. Harmache et al.) but is much more divergent in Env when compared to the subgroup A clones Petaluma (34TF10) and FIV-PPR (76 and 78% divergence, respectively). Clone FIV-C36 was able to infect freshly isolated feline peripheral blood mononuclear cells and primary T-cell lines but failed to productively infect CrFK cells, as is typical of FIV field isolates. Two-week-old specific-pathogen-free cats infected with FIV-C36 tissue culture supernatant became PCR positive and developed severe acute immunodeficiency disease similar to that caused by the uncloned CABCpady00C parent. At 4 to 5 weeks postinfection (PI), 3 of 4 animals developed CD4(+)-T-cell depletion, fever, weight loss, diarrhea, and opportunistic infections, including ulcerative stomatitis and tonsillitis associated with abundant bacterial growth, pneumonia, and pyelonephritis, requiring euthanasia. Histopathology confirmed severe thymic and systemic lymphoid depletion. Interestingly, the dam also became infected with a high viral load at 5 weeks PI of the kittens and developed a similar disease syndrome, requiring euthanasia at 11 weeks PI of the kittens. This constitutes the first report of a replication-competent, infectious, and pathogenic molecular clone of FIV-C. Clone FIV-C36 will facilitate dissection of the pathogenic determinants of FIV.
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PMID:Characterization of a highly pathogenic molecular clone of feline immunodeficiency virus clade C. 1530 94

The only indications for which a fluoroquinolone (ie, ciprofloxacin) is licensed by the US Food and Drug Administration for use in patients younger than 18 years are complicated urinary tract infections, pyelonephritis, and postexposure treatment for inhalation anthrax. Nonetheless, approximately 520,000 prescriptions for fluoroquinolones were written in the United States for patients younger than 18 years in 2002; 13,800 were written for infants and children 2 to 6 years of age, and 2750 were written for infants younger than 2 years. Clinical trials of fluoroquinolones in pediatric patients with various diagnoses have been published and are reviewed. Fluoroquinolones cause arthrotoxicity in juvenile animals and have been associated with reversible musculoskeletal events in both children and adults. Other adverse events associated with fluoroquinolones include central nervous system disorders, photosensitivity, disorders of glucose homeostasis, prolongation of QT interval with rare cases of torsade de pointes (often lethal ventricular arrhythmia in patients with long QT syndrome), hepatic dysfunction, and rashes. The increased use of fluoroquinolones in adults has resulted in increased bacterial resistance to this class of antibacterial agents. This report provides specific guidelines for the systemic use of fluoroquinolones in children. Fluoroquinolone use should be restricted to situations in which there is no safe and effective alternative to treat an infection caused by multidrug-resistant bacteria or to provide oral therapy when parenteral therapy is not feasible and no other effective oral agent is available.
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PMID:The use of systemic fluoroquinolones. 1695 Oct 28

Acute uncomplicated pyelonephritis is a bacterial infection of the renal parenchyma, common in women. The bacterium responsible is usually Escherichia coli. Empirical antibiotic therapy should be initiated promptly to prevent serious complications. As of 2014, which empirical antibiotic regimen should be offered to non-pregnant adult women with acute uncomplicated pyelonephritis, while awaiting the results of antimicrobial susceptibility testing? We reviewed the available evidence using the standard Prescrire methodology. Certain oral fluoroquinolones were effective in a few clinical trials in the 2000s and 2010s: ciprofloxacin and levofloxacin, an isomer of ofloxacin. Symptoms resolved within 5 to 7 days in about 96% of the women. In France, in 2011, about 10% of E. coli isolated in community laboratories from outpatients with urinary tract infections were resistant to ciprofloxacin. Resistance is mainly a problem in patients treated with a quinolone during the preceding months and in recently hospitalised patients. In hospital laboratories, the fluoroquinolone resistance rate was about 18% in 2012 in France, and even higher in some other European countries. The main harms of fluoroquinolones are neuropsychiatric disorders, photosensitivity, tendon disorders, arrhythmia and cardiac conduction disorders, and Clostridium difficile infection. Injectable "third-generation" cephalosporins, such as ceftriaxone, are often effective against enterobacteria, in particular E. coli, and have good kidney penetration. The prevalence of E. coli resistance to third-generation cephalosporins is rising rapidly in France, particularly in hospitals: 1% in 2005 versus 10% in 2012. The main harms of cephalosporins are hypersensitivity reactions and C. difficile infection. Monotherapy with an aminoglycoside is an alternative that has not been evaluated in this clinical situation. Due to the serious irreversible adverse effects of aminoglycosides (nephrotoxicity, ototoxicity), they should only be used when the other options are unacceptable. In practice, as of 2014, the first-choice empirical antibiotic treatment for acute uncomplicated pyelonephritis remains an oral fluoroquinolone (ciprofloxacin or ofloxacin) or, in certain cases, the injectable third-generation cephalosporin ceftriaxone. Given the rapid development of bacterial resistance, broader-spectrum antibiotics should not be used as empirical therapy, to preserve their efficacy in serious infections. The empirical treatment should be adjusted as soon as the results of antimicrobial susceptibility testing are known. Whenever possible, it is preferable to avoid the use of fluoroquinolones and third-generation cephalosporins in non-serious infections such as cystitis.
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PMID:Antibiotic therapy for acute uncomplicated pyelonephritis in women. Take resistance into account. 2562 48