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

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

Cefpirome (HR 810) is a new cephalosporin with a 2,3-cyclopentenopyridine group in the 3-position side chain. It was compared with other cephem antibiotics in protective and therapeutic effects on various experimental infections, systemic and local, in mice and rats. HR 810 had more potent protective effect than ceftazidime (CAZ), cefoperazone (CPZ), and cefotaxime (CTX) on systemic infections induced by Escherichia coli Ec-31, Staphylococcus aureus SMITH, and Serratia marcescens Sm-6 in mice. Against systemic infection with Pseudomonas aeruginosa HR 810 was as effective as CAZ. Mice with leukopenia induced by cyclophosphamide were systemically infected with methicillin-resistant S. aureus (MRSA), methicillin-susceptible S. aureus (MSSA), Enterobacter cloacae, Acinetobacter calcoaceticus, and Enterococcus faecalis. HR 810 was superior to cefuzonam (CZON) and cefmetazole against MRSA and MSSA and was much more active than any other antibiotics tested against E. cloacae and A. calcoaceticus. In the activity against E. faecalis, HR 810 was inferior to ampicillin but superior to CZON. In mice with pyelonephritis caused by E. coli Ec-7, the rank order of activities was HR 810 greater than CAZ greater than CTX greater than CPZ. HR 810 was more effective than latamoxef, CAZ, CTX, and CPZ in improving lung infections induced by Streptococcus pneumoniae HL 438 and Klebsiella pneumoniae Kp-51 in mice. HR 810 was superior to CTX and CPZ and comparable to cefazolin in therapeutic effects on intrauterine infections with E. coli Ec-89 and S. aureus SMITH in rats.
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PMID:Therapeutic effects of cefpirome, a new cephalosporin, on various models of infections in mice and rats. 219 11

The therapeutic effect of Pefloxacin in the treatment of acute pyelonephritis was examined in a randomized clinical trial. The patients in the control group have been treated by gentamycin. With a success rate of 80% in the treatment of acute pyelonephritis caused by various bacteria (E. coli, Pseudomonas, Klebsiella, Staphylococcus aureus, Proteus mirab.), a side frequency of side effects and a good compliance Pefloxacin is recommended as an effective antimicrobiell drug.
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PMID:[A clinical trial of pefloxacin (Abaktal) in the treatment of acute pyelonephritis]. 219

Urinary tract infection contributes to the morbidity of pregnancy since 4-10 percent of antepartum patients have asymptomatic bacteriuria and 20-40 percent of these will result in pyelonephritis. A cost-effective outpatient assessment for asymptomatic bacteriuria in undelivered obstetric patients is described. In this study, 56 patients between 6-24 weeks gestation were assessed over a seven-month period by photometric urinary screening. This assessment was more accurate in identifying those patients with asymptomatic bacteriuria than prior history or symptoms. A 7 percent incidence of asymptomatic bacteriuria was noted with 75 percent being Escherichia coli and the remainder Klebsiella. Single-dose, oral antibiotic therapy was evaluated and resulted in no recurrences. Such screening for asymptomatic bacteriuria was felt to represent preventive and economic medical benefits.
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PMID:Correlation of urinary tract infection with urinary screening at the first antepartum visit. 223 2

Clinical studies on S 6472, a longer lasting preparation of cefaclor (CCL), were performed and the following results were obtained. S 6472 was administered orally to 102 patients with urinary tract infections including 16 with acute uncomplicated pyelonephritis, 32 with acute uncomplicated cystitis, 31 with complicated pyelonephritis and 23 with complicated cystitis. 95 patients were treated with 375 mg of S 6472 2 times daily and 7 patients were treated with 750 mg of S 6472 2 times daily. The overall clinical efficacy was evaluated on the basis of the criteria proposed by the Japanese UTI Committee. 1. Clinical efficacies in 11 cases of acute uncomplicated pyelonephritis were excellent in 10 and moderate in 1, with an overall efficacy rate of 100%. Bacteriologically, all 12 strains identified in the acute uncomplicated pyelonephritis cases were eradicated, with an eradication rate of 100%. 2. Clinical efficacies in 21 cases of acute uncomplicated cystitis were excellent in 17, moderate in 3 and poor in 1, with an overall efficacy rate of 95%. As to bacteriological responses, 22 strains identified in the acute uncomplicated cystitis cases (except 1 of Escherichia coli) were eradicated, with an eradication rate of 95%. 3. Clinical responses in 43 cases of complicated urinary tract infections were excellent in 20, moderate in 15 and poor in 8, with an overall efficacy rate of 81%. Bacteriologically, 39 strains, including only one strain of P. aeruginosa, in the complicated urinary tract infection cases (except 4 of E. coli, 1 of Klebsiella pneumoniae, 1 of Enterococcus faecalis and 2 of Enterobacter cloacae) were eradicated, with an eradication rate of 83%. As side effects, slight stomatitis and gastric discomfort were noted in 1 patient each but we were able to continue the medication. Abnormal laboratory test values found were: 1 case of a slight and transient increase of lymphocytes in peripheral blood and 1 case of a slight and transient increase of serum creatinine level.
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PMID:[Clinical study of S 6472 in urinary tract infection]. 228 54

The authors report on a case of a emphysematous pyelonephritis due to Klebsiella pneumoniae, occurring in a diabetic patient and successfully treated by nephrectomy. They compare it to the literature.
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PMID:[Emphysematous pyelonephritis]. 231 12

We have evaluated 283 consecutive hospital acquired urinary tract infections (HAUTI) in a University hospital (incidence 5.6% of admissions). In females, spontaneous, symptomatic and younger patient infections predominated, while in males HAUTI were mostly asymptomatic, after catheterization and in elderly patients. Chronic nonfatal diseases--particularly neurologic disease and diabetes--, old age, previous antibiotic use, the postoperative period, and cancer were the major general predisposing factors, mostly because they involved urological procedures. There was an urethral catheter in 78% of cases, with questionable indication or maintenance in 37%. In 65% of cases there were clinical data attributable to HAUTI; however, on strict criteria only 5% of pyelonephritis and 24% of cystitis were detected. Mortality rate was 0.4%. Etiology was E. coli in 29%, Proteus in 13%, Enterobacter in 12%, enterococcus in 11.5%, Serratia in 7%, Pseudomonas in 6.5%, and Klebsiella in 6.5%. There were differences regarding endogenous and hospital flora on the basis of sex, hospital situation, catheterization, mobility, and previous duration of hospitalization. The microbial resistance pattern was high in the hospital flora. The major therapeutical problem was the high number of unnecessary treatments representing the automatic medical response to the finding of a positive urine culture.
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PMID:[Nosocomially acquired infection of the urinary tract]. 249 Aug 55

The therapeutic efficacy of ticarcillin/clavulanate was assessed in 71 patients with severe infections: 38 acute pyelonephritis, 16 septicaemia and 19 miscellaneous infections. The patients were classified according to their renal function in: Group A, normal (16 cases); B, mild renal impairment (RI) with creatinine clearance (Clcr) between 80 and 40 ml/min (18 cases); C, moderate RI with Clcr between 40 and 15 ml/min (12 cases); D, severe RI with (Clcr) between 15 and 5 ml/min (13 cases) and E, terminal with (Clcr) less than 5 ml/min (12 cases). A total of 105 microorganisms (48.6% resistant to ticarcillin): 31 Pseudomonas aeruginosa, 18 Escherichia coli, 21 other Enterobacteriaceae, 2 Haemophilus influenzae, 10 Bacteroides spp., 14 enterococci, 8 staphylococci and 1 streptococcus, were isolated. All except six Ps. aeruginosa were sensitive to ticarcillin/clavulanate, using 75:10 microgram discs. Bacteriological eradication was obtained in 97% of the cases on the third day and at the end of treatment, and in 82% of the cases after one month. In all the assessable cases, the clinical symptoms disappeared on the third day except in one patient who developed a resistant strain (Klebsiella oxytoca). The wide range of bacteria assessed and the clinical-bacteriological success rates demonstrated that the ticarcillin/clavulanate combination had an efficacy/safety profile that could be considered excellent. Tolerance was good and side effects were not observed. This study confirms the practical efficacy of the recommended dosages derived from our previous kinetic studies in RI.
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PMID:Ticarcillin/clavulanate in severe infections in patients with varying renal function. 260 15

Oral ciprofloxacin has been shown to be effective in the treatment of infections due to gram-positive cocci and gram-negative rods. The efficacy and safety of intravenous ciprofloxacin was compared with that of intravenous ceftazidime in the treatment of 59 patients with well-documented serious infections in a prospective, controlled, randomized study with a third-party blinding. Thirty-three patients were treated with intravenous ciprofloxacin (200 mg every 12 hours, plus a daily extra placebo dose); 26 patients were treated with ceftazidime (1 g every eight hours). The severity of the infections, underlying diseases, and demographic features were comparable in both groups, although there were more men in the ciprofloxacin group. For ciprofloxacin/ceftazidime treatments, respectively, the evaluated infections were: pyelonephritis (16 patients/nine patients), pneumonia (three/five), soft-tissue infections (four/zero), spontaneous peritonitis (five/two), primary bacteremia (three/eight), and other (two/two). Isolated pathogens included: Escherichia coli (22/12), Klebsiella sp. (five/four), Pseudomonas aeruginosa (two/three), Haemophilus influenzae (one/one), Proteus mirabilis (two/zero), Proteus vulgaris (one/zero), Salmonella sp. (zero/two), Plesiomonas shigelloides (one/zero), and others (one/four). The clinical responses were cure or improvement in 31 ciprofloxacin cases/21 ceftazidime cases; failure, zero/four; and indeterminate, two/one. The bacteriologic responses were eradication in 28 ciprofloxacin cases/22 ceftazidime cases; persistence, one/three; and indeterminate, four/one. Mild intolerance occurred in three ciprofloxacin cases and two ceftazidime cases. A mild increase in serum hepatic enzymes was observed in two patients in each group. Superinfections occurred in five patients: enterococcal septicemia (zero/two) and urinary tract infections (one/two). The results presented suggest that intravenous ciprofloxacin is an effective and safe antimicrobial agent for the treatment of serious infections, with an efficacy comparable with that of ceftazidime, a broad-spectrum cephalosporin. An additional advantage seems to be a lower rate of superinfections.
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PMID:Intravenous ciprofloxacin and ceftazidime in serious infections. A prospective, controlled clinical trial with third-party blinding. 268 25


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