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)

Clinical efficacy of Cefmetazole was evaluated at four university hospitals and their related hospitals in Nagoya. For the treatment of urinary tract infections with or without complications, 177 patients were administered Cefmetazole. Of these patients, 69 had chronic complicated urinary tract infection defined in the UTI manual and 20 had simple acute pyelonephritis. The other urological infections for which Cefmetazole was administered included prostatitis, epididymitis, urosepsis and wound infections. Fifty four patients were given Cefmetazole intravenously after urological operation to prevent wound and urinary tract infections. The overall clinical efficacy of Cefmetazole for UTI was 76.8%; 84.4% for group 1, 85.7% for group 3, 75% for group 4, 44.4% for group 5 and 66.6% for group 6. In acute pyelonephritis due to E. coli, Klebsiella, Serratia, S. aureus, alpha-Streptococcus and S. epidermidis all patients were cured by Cefmetazole administration. Clinical efficacy of Cefmetazole was assessed to be excellent in 6 cases of prostatitis and 6 cases of acute epididymitis. E. Coli, Serratia and some organisms disappeared from blood after the administration of Cefmetazole but Pseudomonas persisted even after treatment. Postoperative administration of Cefmetazole was effective for eradication of bacteria from the urine in 26 out of 30 patients and in prevention of infection in 24 cases. After the administration of Cefmetazole skin eruption was observed in one patient and nausea in another. Slight elevation of GOT, GPT and total bilirubin was noted in 3 of the 177 patients after medication.
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PMID:[Clinical evaluation of cefmetazole in urological infections]. 658 64

Netilmicin was administered to 1 case of simple acute pyelonephritis and 21 cases of complicated urinary tract infections, 22 cases in total, and the effects were evaluated clinically. Total clinical effects of netilmicin evaluated by the UTI standard for evaluation of drug effects showed 61.9% of clinical effectiveness in 21 cases, and the results are satisfactory because 11 cases out of 21 cases were catheterized. The result was examined bacteriologically; the frequency of detection of particular strains among 23 strains clinically isolated from complicated urinary tract infections was that 10 strains of P. aeruginosa (43.5%), 3 of S. marcescens (13.0%), and 3 of E. coli (13.0%), and the ratios of bacteriologically disappeared strains were 70%, 33.3% and 66.7%, respectively, and the overall disappearance ratio was 73.9%. The MIC's determined for 17 strains and disappearance of the bacteria were examined; when MIC was less than 6.25 mcg/ml, 10 strains out of 12 disappeared, that is, 83% of disappearance was obtained. When MIC was larger than 100 mcg/ml, 2 strains out of 5 disappeared, that is, 40% of disappearance was obtained. Disappeared 2 strains of bacteria were isolated from patients who were not catheterized. Neither subjective symptoms nor abnormal laboratory findings related to the drug were observed. It may be said from these findings that netilmicin is an effective drug for urinary tract infections.
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PMID:[Clinical evaluations of netilmicin in urinary tract infections]. 715 43

Using a mouse experimental UTI (urinary tract infection) model, a study was conducted to find the pathogenicity of various serovars of E. faecalis. On the basis of studies employing serovar-specific factor sera prepared with E. faecalis type strains, serovar 2, 3, 4 and 10 strains showed a high incidence of involvement in pyelonephritis: 90.3%, 85.7%, 85% and 73.3%. Serovar 1, 6 and 7 strains each showed a 63.6% incidence of involvement in pyelonephritis, indicating that they have a moderate pathogenicity. The pathogenicity of the other serovar strains was not very strong, with a low incidence of 40-59.1%. These results were thus in good agreement with the findings of the study using the mouse experimental UTI model infected with clinical isolates. Serotyping was performed of E. faecalis clinical isolates obtained from patients with pyelonephritis or urosepsis. Serovars 2 and 4 comprised 75.1% of these isolates. It was surmised that E. faecalis serovars 2 and 4 tend to have strong pathogenicity. Thus, there were quite a few differences in pathogenicity of E. faecalis according to each kind of serovar.
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PMID:[Study of pathogenicity of various serovars of Enterococcus faecalis]. 774 94

Bacterial UTIs are a common problem in patients with diabetes mellitus. Bacteriuria is more common in diabetic women than in non-diabetics owing to a combination of host and local risk factors. Upper tract disease is also more common in this group. Diabetics are at higher risk for intrarenal abscess, with a spectrum of disease ranging from acute focal bacterial pyelonephritis to renal corticomedullary abscess to the renal carbuncle. A number of uncommon complicated UTIs, such as emphysematous pyelonephritis and emphysematous pyelitis, occur more frequently in diabetics. Because of the frequency and severity of UTI in diabetics, prompt diagnosis and early therapy is warranted.
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PMID:Bacterial urinary tract infections in diabetes. 776 19

Prevention of UTI appears to be the most important way to avoid the serious complications of vesicoureteral reflux, which then requires early recognition, ideally prior to bacterial invasion. With early evaluation of children noted to have dilated collecting systems in utero and the screening of siblings and offspring of those with reflux, this prevention becomes possible. This screening should be performed in the first weeks to months after birth, before the first UTI. The choice of management appears to be less important than control of infection, because the results of both medical and surgical management are equal; however, because mild-to-moderate (grades I-III) reflux is likely to resolve, it seems appropriate to pursue an aggressive nonsurgical course in these patients, at least until some minimally invasive, safe interventional treatment becomes available. If reflux remains severe (grades IV and V) beyond 24 to 48 months of age, surgical intervention appears appropriate because resolution is unlikely, assuming, of course, that an experienced surgeon performs the procedure. As was evident from the European branch of the IRS, renal scarring occurred most frequently in the few patients who had ureteral obstruction after failed surgical correction. In those who continued to have mild reflux beyond 5 to 7 years of age, a trial of medication is justifiable. If infection occurs during that time and reflux persists, correction should be considered for those with clinical or scan-documented pyelonephritis. Patients who have reflux plus bacteriuria present a special problem because it is unclear whether their risks are increased. Finally, we must forewarn all our female patients with UTI in childhood that they are at risk for bacilluria during pregnancy and may require prophylaxis regardless of the state of their reflux at that time.
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PMID:A perspective on vesicoureteral reflux. 785 50

A total of 146 Klebsiella isolates from human asymptomatic bacteriuria (n = 73), cystitis (n = 54), and acute pyelonephritis (n = 19) were examined for the presence of particular virulence factors. Capsular type K2 was the most common serotype observed (13%). This capsule type was prevalent in isolates from asymptomatic bacteriuria and cystitis but not from pyelonephritis. Type 1 fimbriae were found significantly more often in pyelonephritis isolates than among those from asymptomatic and symptomatic lower urinary tract infection (UTI; P < .05), while no marked differences were detected with respect to the distribution of type 3 fimbriae. Serum resistance was more frequent among isolates from symptomatic (26%) than from asymptomatic UTI (18%). Enterochelin was produced by all but 1 of the isolates as determined by a bioassay. In contrast, aerobactin synthesis was rare (3%), with isolates from pyelonephritis showing the highest frequency of aerobactin production (3/19).
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PMID:Serotypes, hemagglutinins, siderophore synthesis, and serum resistance of Klebsiella isolates causing human urinary tract infections. 790 83

The efficacy and safety of cefpirome was reviewed from the documentation of comparative pivotal trials in patients with urinary tract or lower respiratory tract infections UTIs and LRTIs, respectively). A majority of patients with UTIs had pyelonephritis and/or complicated UTIs. Most patients with LRTIs had community acquired pneumonia. Studies of UTI included 865 patients treated with cefpirome 1 g bid and 443 patients allocated to ceftazidime 1 g bid. Satisfactory clinical outcome was reported in 87% and 83%, respectively. Eradication of organisms causing bacteriuria was achieved in 87% and 86%, respectively. In the LRTI trials 199 patients received cefpirome 1 g bid and in 653 patients it was dosed 2 g bid. Comparators were ceftazidime 2 g bid (N = 197) or 2 g tid (N = 296) or ceftriaxone 1 g bid (N = 77). With all treatments unsatisfactory clinical or bacteriological outcome was recorded in < 15% of the patients. The safety of cefpirome and comparators was evaluated in pivotal phase II and III studies and deaths were analysed in all clinical trials for which data were available by June 30th 1991. Cefpirome did not differ from comparators in terms of frequencies or distribution within body systems of adverse events. Death rates were 3.9% in 9189 patients receiving cefpirome and 5.1% in 3162 receiving a comparator. The deaths were in an absolute majority of cases not considered related to study drug given. The most common cause of death was infection, indicating that the trial samples were selected from populations of patients with serious infections. Cefpirome was as safe and efficaceous as its comparators and is a new injectable cephalosporin with broader spectrum than ceftazidime. It should be a suitable alternative for empiric treatment of serious infections in hospitalised patients.
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PMID:Cefpirome: efficacy in the treatment of urinary and respiratory tract infections and safety profile. 829 Sep 2

The Authors report their experience about two cases of xanthogranulomatous pyelonephritis in childhood. The clinical history, diagnostic procedures and surgical treatment are described. The xanthogranulomatous pyelonephritis is a rare form of chronic inflammatory disease of the kidney, in which pre-operative differential diagnosis with renal cancer or with extra renal neoplastic and inflammatory diseases is very difficult. The signs and symptoms are not characteristic, such as renal tumour, recurrent UTI, abdominal pain, fever. Also non characteristic are the findings, performed with diagnostic ultra sound and computed tomography. The surgical treatment is always effective in the xanthogranulomatous pyelonephritis. About 500 cases are described in adults and about 80 cases in children, from the first description in 1963. The first of our cases, occurring in a boy 6 years old, was treated with nephrectomy, because of the pre-operatory aspect was like tumour. In the second of the cases described, occurring in a girl 11 years old, the nephrectomy was performed because the chronic purulent inflammatory process had involved all the kidney. In the post-operative, in the first case was performed a relaparotomy for intestinal occlusion in 12th day, in the second case the post-operative was uneventful. The Authors emphasize the importance of the xanthogranulomatous pyelonephritis in the differential diagnosis in children with recurrent UTI, renal masses, fever, in the clinical history.
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PMID:[Xanthogranulomatous pyelonephritis in childhood: considerations on 2 new cases]. 848 32

UTI is a common and important clinical problem in infants and young children, with a prevalence of 5.3% among febrile infants seen in our Emergency Department. White females with rectal temperature > or = 39 degrees C are at particularly high risk (prevalence, 17%). Several studies have highlighted the limitations of the standard urinalysis for identifying UTI in infants and young children and have recommended performance of both urinalysis and urine culture. Alternative methods such as dipstick urinalysis, although attractive because of ease of performance, are inadequate as a screen for UTI. Hemocytometer WBC counts of an uncentrifuged urine specimen can be performed in an office or hospital-based laboratory with minimal training. Performance of Gram-stained smears, however, is most appropriate for the hospital-based laboratory. In the hospital setting where both tests can readily be performed, the positive predictive value of the combination of pyuria and bacteriuria (85%) allows prompt institution of antimicrobial therapy before culture results are available, whereas the lower positive predictive value of the single finding of either pyuria or bacteriuria (40%) justifies delaying treatment decisions until culture results are available. In the office setting where hemocytometer counts can easily be performed, culturing only specimens with pyuria and those of children presumptively treated with antimicrobials will result in the identification of almost all patients with true UTI, sparing large health care expenditures. Although the urine culture is traditionally regarded as the gold standard of UTI, positive urine cultures may occur secondary to contamination or in cases of ABU, leading to a false diagnosis of UTI. In contrast we found pyuria to be a reliable marker to discriminate infection from colonization of the urinary tract. The sustained absence of an inflammatory response, on repeat UA within 24 h, constitutes strong evidence that infection is absent. Management of ABU is controversial; many experts recommend withholding antibiotics because eradication of low virulence organisms may be followed by colonization with more virulent species that cause pyelonephritis. Preliminary results of our ongoing treatment trial suggest that management of young febrile children with UTI as outpatients receiving oral cefixime is as efficacious as inpatient management with intravenous cefotaxime. Results of renal ultrasound and DMSA scan at the time of infection have not modified management in any patient. Accordingly selective rather than routine performance of ultrasound is recommended. A voiding cystourethrogram at 1 month and a DMSA scan 6 months later have been valuable in identifying patients with vesicoureteral reflux and renal scarring, respectively. Among patients initially identified as having acute pyelonephritis, the incidence of renal scarring at 6 months has been substantially more frequent (approximately 40%) than we had expected. However, the long term implications of small scars identified with renal scintigraphy remain to be determined.
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PMID:Urinary tract infections in young febrile children. 900 94

The role of type-1 fimbriae in the pathogenesis of chronic pyelonephritis was studied for two Escherichia coli strains. Although both strains produced a similar total oxidative burst of chemiluminescence in macrophages from uninfected mice, the extracellular oxidative burst was greater with the non-fimbriate mutant E. coli BH-5 than its type-1 fimbriate parent E. coli 31-B. Moreover, macrophages from mice infected with the non-fimbriate mutant gave a much greater oxidative burst when stimulated with latex particles than that given by macrophages from mice infected with the type-1 fimbriate parent. These results correlated with the degree of renal inflammation and scarring as measured by malondialdehyde formation. Hence, the role of type-1 fimbriae in the pathogenesis of chronic UTI although documented does not appear to be significant.
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PMID:Role of type-1 fimbriae in the pathogenesis of chronic pyelonephritis in relation to reactive oxygen species. 915 36


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