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

The medical history of 256 hypertensive and 263 normotensive pregnant women was analysed retrospectively. There was a negative correlation (P less than 0.01) between the maximal pretreatment diastolic blood pressure and the birth weight of newborns in the hypertensive group. The prevalence of a hypertensive family history, pyelonephritis, proteinuria, delivery by Caesarean section, fetal asphyxia during delivery and death of the newborn during delivery was significantly higher in the hypertensive group than in the normotensive one. The gestational age at delivery was shorter and the birth weight of the newborn was lower in the hypertensive women than in the normotensive women.
J Hypertens Suppl 1989 Dec
PMID:Retrospective analysis of clinical data of normotensive and hypertensive pregnant women and their newborns. 263 37

Acute urinary tract infection is a major health problem among women, accounting for considerable morbidity and health care costs. We review recent developments in the diagnosis and treatment of these infections. In acute lower urinary tract infection, empiric short-course therapy (single-dose or 3-day therapy) with one of several antibiotics is recommended in the absence of complicating factors. When complicating factors are present, the antibiotic susceptibility profile of the infecting organism should be determined and therapy with an appropriate agent should be provided for 7 days. Ampicillin and related drugs are probably inferior to trimethoprim-sulfamethoxazole in the treatment of occult renal infection. In acute pyelonephritis, most patients require hospitalization and treatment with intravenous antibiotics until they can take oral medications. In uncomplicated cases, a single broad-spectrum intravenous agent can be used initially, followed by an oral agent selected on the basis of antibiotic-susceptibility testing results. Patients with uncomplicated acute pyelonephritis who are less ill can be managed with oral therapy as outpatients, again with reference to the results of antibiotic-susceptibility testing. Complicated acute pyelonephritis requires more aggressive diagnostic and therapeutic measures. Therapy for uncomplicated acute pyelonephritis should be given for 14 days. The role of post-therapy cultures in the management of urinary tract infection is not well defined, but cultures probably can be safely omitted in most cases of uncomplicated acute cystitis.
Ann Intern Med 1989 Dec 01
PMID:Urinary tract infections in women: diagnosis and treatment. 236 59

The development of renal scarring was analyzed prospectively in 241 boys with their first known episode of symptomatic urinary tract infection (140 acute pyelonephritis, 61 acute cystitis, and 40 nonspecific). Of 197 boys undergoing urography, 22 (11%) had scars; 20 were in the pyelonephritis group. Vesicoureteral reflux occurred in 81% of those with scarring, compared with 20% of those without scarring. The bacteria causing the first episode of urinary tract infection in each patient were saved, and Escherichia coli organisms were characterized for the expression of both galactose-alpha (1----4)galactose-beta (Gal-Gal)-specific adhesins and pap homologous DNA. Scarring occurred in 41% and other renal abnormalities in 11% of boys infected with bacteria that did not bind Gal-Gal (Gal-Gal negative), compared with 5% and 1%, respectively, in those infected with Gal-Gal-binding strains (Gal-Gal-positive) (relative risk 8.3; 95% confidence limits 3.3 to 20.4; p less than 0.001). That boys infected with Gal-Gal-negative strains more often had reflux did not explain the increased risk for renal scarring in this group. The possibility that the phenotypically negative strains could be induced to express Gal-Gal adhesions in vivo was excluded by dot blot analysis, which showed the absence of pap homologous DNA in all but one of the Gal-Gal-negative strains. The results suggest that the absence of Gal-Gal-specific adhesins in E. coli can be used as an indicator of risk for renal scarring and the need for radiologic examination.
J Pediatr 1989 Dec
PMID:Bacterial attachment as a predictor of renal abnormalities in boys with urinary tract infection. 268 19

This article provides the primary care physician with the rationale and guidelines for the diagnosis and treatment of common male genitourinary tract infections. Disease entities include urethritis, cystitis, pyelonephritis, epididymitis, and orchitis. The format of pathogenesis, epidemiology, diagnosis, and management will facilitate use by the primary care physician for a specific patient.
Prim Care 1989 Dec
PMID:Infections of the male genitourinary system. 269 46

The comparative study of the biological properties of E. coli cultures, isolated from the urine of 7 patients two times during the first 11 days from the beginning of clinical manifestations of the exacerbation of chronic pyelonephritis, was conducted. In most cases the strains obtained as the result of the inoculations of the first and second urine samples belonged to the same serological and enzymatic variants. Still bacteria isolated in the second investigation, in contrast to E. coli obtained by the earlier inoculation of urine samples, often had no hemagglutinins and showed low adhesive capacity with respect to uroepithelium. Only in one out of 4 patient E. coli with antigen K1+ could be detected not only after the first inoculation, but also after the second one. In 4 patients E. coli cultures obtained as the result of the second isolation of these bacteria had lower content of sialic acid. Besides, differences in the sensitivity of E. coli strains isolated from the same patients in the course of the infectious process to the action of nonspecific protection factors of the body were established. The results obtained in the course of this study give more precise understanding of the existing conception of the pathogenesis of pyelonephritis.
Zh Mikrobiol Epidemiol Immunobiol 1989 Dec
PMID:[A comparative study of the biological properties of pyelonephritogenic Escherichia coli isolated at different times in the infectious process]. 269 29

Based on the examination of 1050 patients the authors make a conclusion of great significance of renoscintigraphy, ultrasonic scanning and thermography for differential diagnostics of acute pyelonephritis, acute cholecystitis and pancreatitis.
Vestn Khir Im I I Grek 1987 Dec
PMID:[Radionuclide, ultrasonic and thermographic methods of examination in the differential diagnosis of acute pyelonephritis and diseases of the abdominal organs]. 285 79

The case history of 88 patients with blood cultures positive for Escherichia coli and evidence of systemic disease was reviewed, and the Escherichia coli blood isolates tested for P-fimbriation. Fifty-five strains (63%) were P-fimbriated. Patients with a positive urine culture had a higher incidence of P-fimbriated Escherichia coli strains (53/75, 71%) than patients with a negative urine culture (2/13, 15%). Patients with no predisposing factors, such as instrumentation of the urinary tract or a chronic disease, had a significantly higher frequency of P-fimbriated strains (31/36, 86%) compared to patients without such underlying factors (p less than 0.01). There was no significant difference in clinical parameters or in frequency of P-fimbriated strains between patients with one positive blood culture and those with two or more positive cultures. The high incidence of P-fimbriated Escherichia coli strains in these patients is thought to depend on the ability of such bacteria to cause acute pyelonephritis, which in many cases precedes Escherichia coli bacteremia.
Eur J Clin Microbiol 1985 Dec
PMID:Occurrence of P-fimbriated Escherichia coli in patients with bacteremia. 286 94

Escherichia coli 536 (O6:K15:H31), which was isolated from a case of urinary tract infection, determines high nephropathogenicity in a rat pyelonephritis system as measured by renal bacterial counts 7 days after infection. The loss of S fimbrial adhesin formation (Sfa-) (mannose-resistant hemagglutination [Mrh-] and fimbria production [Fim-]), serum resistance (Sre-), and hemolysin production (Hly-) in the mutant 536-21 led to a dramatic reduction of bacterial counts from almost 10(5) to only 40 cells per g of kidney. The reintroduction of the cloned S fimbrial adhesin determinant (sfa) increases the virulence of the avirulent mutant strain by a factor of 20; almost the same effect was observed after restoration of serum resistance by integration of an sfa+ recombinant cosmid into the chromosome. Additional reintroduction of the Hly+ phenotype by transformation of two hly determinants increased the virulence of the strains. Hemolysin production determined increased renal elimination of leukocytes and erythrocytes. Thus all three determinants investigated, S fimbriae, serum resistance, and hemolysin, contribute to the multifactorial phenomenon of E. coli nephropathogenicity.
Infect Immun 1986 Dec
PMID:Contribution of cloned virulence factors from uropathogenic Escherichia coli strains to nephropathogenicity in an experimental rat pyelonephritis model. 287 50

The aim of the study was to investigate the properties of fecal P-fimbriated Escherichia coli strains in neonates and to relate these characteristics to the later development of acute pyelonephritis. In a 2 1/2 year prospective study of the children admitted to a particular neonatal ward, 113 children were found to be fecally colonized with a P-fimbriated Escherichia coli strain. However, only one of these children developed pyelonephritis from this strain during the first year of life. The combined results of serotyping, biochemical phenotyping and determination of outer membrane protein pattern as clonal characterization suggested that only 26 of the P-fimbriated strains belonged to a pyelonephritogenic Escherichia coli clone. It is concluded that the risk of a child colonized with an Escherichia coli strain belonging to such a clone of developing pyelonephritis, as calculated in this study, is about 4%.
Eur J Clin Microbiol 1986 Dec
PMID:Fecal colonization with pyelonephritogenic Escherichia coli in neonates as a risk factor for pyelonephritis. 287 31

We designed a retrospective study to determine the incidence of P-fimbriated Escherichia coli in patients with asymptomatic bacteriuria, acute urethral syndrome, bacterial cystitis, acute pyelonephritis, possible acute pyelonephritis, and acute and chronic prostatitis. In addition, we compared the incidence in uncompromised vs compromised hosts, inpatients vs outpatients, and children vs adults. P-fimbriated E coli were isolated in more than 80% of uncompromised patients with either acute pyelonephritis or acute prostatitis. In clinically compromised patients having these disorders, the incidence dropped to approximately 30% (P less than .025). Neither age nor inpatient/outpatient status was a significant factor. We stress the importance of P-fimbriation as a virulence factor in acute pyelonephritis and acute prostatitis caused by E coli, though these diseases may be caused by less virulent organisms in compromised patients. Thus, patients with acute pyelonephritis or acute prostatitis caused by E coli negative for P-fimbriae probably should be considered compromised; the compromising factor should be determined as a guide to subsequent treatment.
South Med J 1987 Dec
PMID:P-fimbriated Escherichia coli urinary tract infection: a clinical correlation. 289 72


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