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

A specific family of glycolipids, the globoseries, was shown to act as receptors on human uroepithelial cells and erythrocytes for the majority of uropathogenic Escherichia coli strains attaching to or hemagglutinating those cells. This was demonstrated in three different ways: (i) correlation between the natural presence of glycolipid in the target cell (erythrocytes of different species) and binding of bacteria; (ii) inhibition of attachment to human uroepithelial cells by preincubation of bacteria and glycolipid; and (iii) induction of binding to unreactive cells by coating of these cells with glycolipid. Strains reacting with the receptor agglutinated guinea pig erythrocytes in a mannose-resistant way after, but not before, coating of the cells with globotetraosylceramide. Unrelated glycolipids were not recognized. The reaction was made independent of simultaneous occurrence of mannose-sensitive adhesions on the strains by addition of D-mannose. The receptor-coated cells were used as a tool to screen for prevalence of receptor recognition in a collection of 453 E. coli strains isolated from patients with urinary tract infection or from the stools of healthy children. Of 150 strains attaching to human uroepithelial cells and agglutinating human erythrocytes, 121 bound to globotetraosylceramide (81%). Globoside recognition was especially frequent among pyelonephritis strains (74/81). The glycolipid composition of the urogenital epithelium and kidney tissue and the ability of uropathogenic E. coli to bind to these glycolipids may be a determinant in host-parasite interaction leading to urinary tract infection.
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PMID:Glycolipid receptors for uropathogenic Escherichia coli on human erythrocytes and uroepithelial cells. 703 45

The virulence of faecal and urinary Escherichia coli strains was studied in relation to serotype, haemolysin production and haemagglutination pattern. By means of an experimental mouse model E. coli strains can be divided into avirulent (I), mouse nephropathogenic (II), and generally virulent (III) strains. Virulent group II and group III strains were more often haemolytic and haemagglutinating than avirulent group I strains. Presence of K antigen could not be associated with virulence. Discriminant analysis for qualitative variables revealed that no combination of the investigated properties contributed more to a strain's virulence level than did one single property. It is concluded that other virulence factors, apart from haemolysin production in group II strains and haemagglutinins in group III strains, must be involved in the determination of a strain's virulence level. All O2, O6 and O18 ac strains tested were virulent, and by far the most O75 strains were avirulent, whereas other O groups were more variable with regard to virulence. Pyelonephritis strains were more often mannose-resistance haemagglutinating than faecal and other urinary isolates, indicating that mannose-resistant adhesins may be important in the pathogenesis of pyelonephritis.
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PMID:Virulence of urinary and faecal Escherichia coli in relation to serotype, haemolysis and haemagglutination. 704 21

A 68-year-old female on two-year chronic hemodialysis for chronic renal failure due to chronic pyelonephritis, was admitted to hospital for weakness, dulled sensorium and dizziness. On examination the patient was in a state of circulatory collapse, the electrocardiogram showed an accelerated idioventricular rhythm and laboratory analysis revealed extreme hyperkalemia (K+ 10.1 mmol/l). There were no common causes of shock, such as hypovolemia, sepsis, heart failure and presence of vasodilator drugs. The patient was treated with calcium gluconate, sodium bicarbonate and sodium chloride (to oppose the effects of hyperkalemia on the cell membrane to minimize cardiac and neuromuscular toxicity), insulin and dextrose (to increase the transport of K+ from the extracellular to the intracellular compartment), and hemodialysis (to remove K+ from the body). At the end of the hemodialysis session, the patient was in a clinically good condition, blood pressure was 160/90 mm Hg and the serum K+ concentration was normal. The case appeared to suggest that extreme hyperkalemia may have direct effects on vascular resistance, causing hypotension and shock.
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PMID:A life-threatening complication of extreme hyperkalemia in a patient on maintenance hemodialysis. 748 41

Renal scars have been thought to occur only in later stages of chronic pyelonephritis. In our experimental pyelonephritis model, bacteria with mannose-sensitive (MS) pili on its surface promoted renal scarring when inoculated into renal parenchyma. Pretreatment with recombinant human granulocyte-colony-stimulating factor (rhGCSF) inhibited the renal scarring which followed inoculation with MS-piliated bacteria, whereas posttreatment at an early stage of infection had no effect on renal scarring. These findings suggest that rhGCSF may be useful for the prevention of infection without increasing the tissue damage to the renal parenchyma which leads to the renal scarring. Even when rhGCSF is used for treatment of kidney infection, it does not promote increased renal scarring through the increased invasion of leukocytes at the inflammatory site.
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PMID:Effect of recombinant human granulocyte-colony-stimulating factor on renal scarring following infection with MS-piliated bacteria. 768 31

A total of 80 Escherichia coli strains were examined for expression of P-fimbriae, mannose-sensitive haemagglutination (MSHA) and mannose-resistant haemagglutination (MRHA) of human group A erythrocytes and guinea pig erythrocytes, cell surface hydrophobicity and resistance to serum bactericidal activity. Isolates were obtained from urine of children and adults, either with acute pyelonephritis (n = 15 and n 12) or lower urinary tract infection (UTI) (n = 30 and n = 23, respectively). Results obtained showed that, in E. coli strains isolated both from children and adults with lower UTI, significant differences were not found concerning the incidence of P-fimbriae, cell surface hydrophobicity and serum resistance. In pyelonephritogenic E. coli isolated from children and adults, the incidence of P-fimbriae and cell surface hydrophobicity was associated more frequently with the former (87% vs. 42% and 100% vs. 67%, P < 0.05), while serum resistance was associated with the latter (47% vs. 67%, P < 0.05).
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PMID:Fimbriation, surface hydrophobicity and serum resistance in uropathogenic strains of Escherichia coli. 781 69

Proteus mirabilis, a cause of urinary tract infection and acute pyelonephritis, produces a number of different fimbriae. An isogenic fimbrial mutant of P. mirabilis HI4320 was constructed by marker exchange with delta pmfA::aphA to determine the role of the P. mirabilis fimbriae (PMF) in hemagglutination and in virulence in the CBA mouse model of ascending urinary tract infection. The pmfA mutant, which did not express the 19,500-Da major subunit of PMF, colonized the bladders of transurethrally challenged CBA mice (n = 20 in each group) in numbers 83-fold lower than those of the wild-type strain (mutant, log10 4.87 CFU/g; wild-type strain, log10 6.79 CFU/g; P = 0.023). However, the mutant colonized the kidneys in numbers similar to those of the wild-type strain. Hemagglutination patterns of the mutant ruled out the involvement of PMF in both mannose-resistant, Proteus-like and mannose-resistant, Klebsiella-like hemagglutination. Similarly, PMF does not appear to be involved in adherence to uroepithelial cells (UEC), since the mutant was as adherent as the wild-type strain (mutant, 14.1 +/- 11.7 mean bacteria per UEC, 60% of UEC with > or = 10 bacteria; wild-type strain, 18.1 +/- 16.2 mean bacteria per UEC, 68% of UEC with > or = 10 bacteria; not significantly different). These data suggest a role for PMF in colonization of the bladder but not in colonization of kidney tissue. PMF appear not to be responsible for mannose-resistant, Proteus-like or mannose-resistant, Klebsiella-like hemagglutination.
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PMID:Proteus mirabilis fimbriae: construction of an isogenic pmfA mutant and analysis of virulence in a CBA mouse model of ascending urinary tract infection. 790 63

Urinary tract infections involving Proteus mirabilis may lead to complications including bladder and kidney stones, acute pyelonephritis, and bacteremia. This bacterium produces a number of fimbriae, two of which, MR/P fimbria and P. mirabilis fimbria, have been shown to contribute to the ability of this pathogen to colonize the bladder and kidney. We have now purified and characterized a previously undescribed fimbria of P. mirabilis, named ambient-temperature fimbria (ATF). Electron microscopy of a pure preparation and immunogold labeling of cells demonstrated that ATF was fimbrial in nature. The major fimbrial subunit of ATF has an apparent molecular weight of 24,000. The N-terminal amino acid sequence, E-X-T-G-T-P-A-P-T-E-V-T-V-D-G-G-T-I-D-F, did not show significant similarity to that of any previously described fimbrial protein. ATF was expressed by all eight P. mirabilis strains examined. Culture conditions affected expression of ATF, with optimal expression observed in static broth cultures at 23 degrees C. This fimbria was not produced by cells grown at 42 degrees C or on solid medium. Expression of ATF did not correlate with mannose-resistant/Proteus-like (MR/P) or mannose-resistant/Klebsiella-like (MR/K) hemagglutination and represents a novel fimbria of P. mirabilis.
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PMID:Proteus mirabilis fimbriae: identification, isolation, and characterization of a new ambient-temperature fimbria. 790 38

Proteus mirabilis, a cause of acute pyelonephritis, produces at least four types of fimbriae, including MR/P (mannose-resistant/Proteus-like) fimbriae. To investigate the contribution of MR/P fimbriae to colonization of the urinary tract, we constructed an MR/P fimbrial mutant by allelic exchange. A 4.2-kb BamHI fragment carrying the mrpA gene was subcloned into a mobilizable plasmid, pSUP202. A 1.3-kb Kanr cassette was inserted into the mrpA open reading frame, and the construct was transferred to the parent P. mirabilis strain by conjugation. Following passage on nonselective medium, 1 of 500 transconjugants screened was found to have undergone allelic exchange as demonstrated by Southern blot. Colony immunoblot, Western immunoblot, and immunogold labeling with a monoclonal antibody to MR/P fimbriae revealed that MrpA was not expressed. Complementation with cloned mrpA restored MR/P expression as shown by hemagglutination, Western blot, and immunogold electron microscopy. To assess virulence, we challenged 40 CBA mice transurethrally with 10(7) CFU of wild-type or mutant strains. After 1 week, geometric means of log10 CFU per milliliter of urine or per gram of bladder or kidney for the wild-type and mutant strains were as follows: urine, 7.79 (wild type) versus 7.02 (mutant) (P = 0.035); bladder, 6.22 versus 4.78 (P = 0.019); left kidney, 5.02 versus 3.31 (P = 0.009); and right kidney, 5.28 versus 4.46 (P = 0.039). Mice challenged with the wild-type strain showed significantly more severe renal damage than did mice challenged with the MR/P-negative mutant (P = 0.007). We conclude that MR/P fimbriae contribute significantly to colonization of the urinary tract and increase the risk of development of acute pyelonephritis.
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PMID:Construction of an MR/P fimbrial mutant of Proteus mirabilis: role in virulence in a mouse model of ascending urinary tract infection. 791 98

One hundred and sixty-eight strains of Escherichia coli were isolated from cases of pyelonephritis (24) and lower urinary tract infections (UTI) (144) from hospitalised and outpatient children up to 2 years old. These strains were investigated for the expression of P fimbriae (PF), mannose-resistant and mannose-sensitive haemagglutination, cell-surface hydrophobicity, serum resistance and the production of alpha-haemolysin (AH), colicins and aerobactin. PF, AH, aerobactin production and serum resistance were significantly more frequent amongst strains expressing mannose-resistant haemagglutination. PF and AH production was significantly more frequent in pyelonephritogenic strains than in lower UTI strains. Serotypes O6 and O112 were isolated most frequently and plasmids were found in the majority of strains tested.
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PMID:Virulence-associated factors in Escherichia coli strains isolated from children with urinary tract infections. 791 74

Escherichia coli strains isolated from the urine in 49 consecutive episodes of community-acquired pyelonephritis in adult women were characterized for adhesins and hemolysin production. The mean age of the patients was 56 years and 47% had at least 1 compromising condition. P fimbriae was found in 67% and hemolysin production in 35% of the strains; these figures were significantly (p < 0.001) higher than the corresponding figures (11% for each) among 287 strains isolated from stool of healthy adults (Siitonen A. J Infect Dis 1992; 166: 1058-1065). The prevalence of Non-P mannose-resistant adhesins and type 1C fimbriae was low (4 and 8%, respectively) and did not differ significantly from the corresponding prevalences (1 and 7%) in healthy adults. 74% fo the pyelonephritic (but only 22% of the stool) isolates had at least 1 of these 4 virulence factors (p < 0.001) and 37% and 7%, respectively, had at least 2 (p < 0.001). Nevertheless, the strains represented a wide variety of O:K serotypes without any indication of specially virulent clones. Of the 49 patients 15 had concomitant bacteremia, and in all except 2 compromised elderly patients the urinary and blood isolates were identical.
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PMID:Community-acquired pyelonephritis in adults: characteristics of E. coli isolates in bacteremic and non-bacteremic patients. 793 28


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