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

Urinary tract infections (UTIs) are the second most common infectious presentations in community practice. Over 90% of UTIs are due to a single species. Escherichia coli alone accounts for 80% to 90% of UTIs. In young, healthy women, Staphylococcus saprophyticus accounts for approximately 5% to 15% of cases of uncomplicated cystitis, but is rarely associated with pyelonephritis or complicated infections. Other gram-negative species comprise the majority of the remaining causes of UTIs. Because initial antimicrobial therapy for UTIs is generally empiric, it is important to account for local susceptibility trends when selecting an antimicrobial agent. In Canada, resistance among community-acquired (as opposed to nosocomial or hospital-acquired) isolates of E. coli varies depending on the antimicrobial agent being tested. Ampicillin has the lowest activity against community-acquired E.coli isolates, with resistance rates ranging from 23% to 41%. Trimethoprim-sulphamethoxazole (TMP-SMX) resistance rates range from 8.4% to 19.2%, while the resistance to the fluoroquinolone ciprofloxacin has remained at 0% to 1.8% since its introduction over 10 years ago. Current studies suggest that there are no regional differences in resistance rates among community-acquired urinary tract pathogens across Canada.
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PMID:Antimicrobial resistance trends in common urinary pathogens. 1144 90

The susceptibility to 12 antimicrobial agents of 165 Escherichia coli isolates from women with acute uncomplicated pyelonephritis of mild to moderate severity was analyzed by geographic region in the US. Ampicillin, trimethoprim, and trimethoprim/sulfamethoxazole resistance exhibited a descending prevalence gradient from west to east. Composite antimicrobial resistance phenotypes also exhibited significant regional differences, with a greater prevalence of most combined resistance profiles seen in the Pacific region of the US, but with significant north-south variation for combined ampicillin/sulfisoxazole resistance. These findings suggest geographical segregation of resistant clones and/or resistance elements among uropathogenic E. coli within the US, which is relevant both to clinical practice and to understanding the basis for the current epidemic of antimicrobial resistance in E. coli.
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PMID:Geographical distribution of antimicrobial resistance among Escherichia coli causing acute uncomplicated pyelonephritis in the United States. 1536 6

The current study aims to the detection of pathogenic potential and virulence factor identification of uropathogenic Escherichia coli BRL-17 isolated from patients urine. The organism was isolated from the patient with chronic pyelonephritis. The identification of organism was done by analyzing gram staining, biochemical, 16S rDNA analysis, Raman microscopy and SEM analysis. The pathogenic potential was identified by multiplex PCR analysis of virulence factor genes like sfa, hly D, pap C. The biofilm forming ability was tested by congo red agar assay and tissue culture plate assay. The result of gram staining and biochemical analysis shows the characteristics of E-coli. The 16S rDNA analysis of the clinically isolated uropathogen showed 100% similarity with uropathogenic Escherichia coli strain. Raman microscopy and SEM confirms the organism as E-coli. The Multiplex PCR study identifies virulence genes like sfa, hly D, pap C in isolated E-coli. The presence of P fimbriae coded pap C gene, S fimbriae coded sfa gene and hemolysin-D coded hly D gene discloses its potential to cause urinary tract infection. Biofilm assay result enhances the organism's role as strong biofilm former. This biofilm forming ability of Escherichia coli strain BRL-17 made the organism to escape from host immune system and helps to colonize in bladder and kidney. This also helps to enhance the resistance to antibiotics. Our study confirms the organism as multidrug resistant, highly virulent, strong biofilm forming E-coli. The strain may be used for the development of animal models of pyelonephritis for the purpose of drug discovery.
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PMID:Studies on biofilm formation and virulence factors associated with uropathogenic Escherichia coli isolated from patient with acute pyelonephritis. 3003 9

Urinary tract infection (UTI) is defined as the growth of microorganisms in a sterile urine culture in a patient with compatible clinical symptoms. The presence of bacteria without any symptoms is known as asymptomatic bacteriuria, and does not require any treatment. In neonates and infants, fever is the guiding sign to suspecting a UTI. Classic urinary tract symptoms become more important in older children. Urine cultures collected before starting antibiotics is always required for diagnosis. Clean-catch (midstream) specimens should be collected for urine culture. In the case of non-toilet-trained children, specimens must be obtained by urinary catheterisation, or suprapubic puncture in neonates and infants. Specimens collected by urine bag should not be used for urine culture. There are no significant differences in the clinical evolution and prognosis between oral versus short intravenous followed by oral antibiotic. Empirical antibiotic therapy should be guided by local susceptibility patterns. Second-generation cephalosporin (children under 6 years) and fosfomycin trometamol (over 6 years), are the empiric therapy recommended in this consensus. In the case of pyelonephritis, recommended antibiotic treatment are third-generation cephalosporins (outpatient care) or, if admission is required, aminoglycosides. Ampicillin should be added in infants less than 3 months old. Antibiotic de-escalation should be always practiced once the result of the urine culture is known.
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PMID:[Recommendations on the diagnosis and treatment of urinary tract infection]. 3215 42


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