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

Long-term urinary catheterization results in polymicrobial bacteriuria and is complicated by fever, bacteremia, acute pyelonephritis, and death. Escherichia coli is a common urine isolate from catheterized patients and can persist for months. We hypothesized that fimbria-mediated adherence contributes to its persistence. For 1 year, urine specimens were collected from 51 patients greater than or equal to 65 years of age who were catheterized for greater than or equal to 30 days. E. coli was isolated at greater than or equal to 10(5) CFU/ml from 447 (36%) of 1,230 weekly urine specimens from 26 patients. Week 1 isolates from 52 definable episodes were tested for hemagglutination, hybridization with gene sequences from the pil and pap operons, in vitro adherence to catheter material, binding of 125I-labeled Tamm-Horsfall protein, hemolysin and colicin V production, and serum resistance. The proportions of isolates of short (1 week only), medium (2 to 11 weeks) and long (greater than or equal to 12 weeks) episodes of bacteriuria which expressed type 1 fimbriae as assayed by mannose-sensitive hemagglutination were 59, 65, and 92%, respectively. Isolates with the pil operon (the genome for type 1 fimbriae) from episodes lasting greater than 1 week expressed mannose-sensitive hemagglutination more frequently (P = 0.011) than pil-positive isolates from episodes of less than or equal to 1 week. Isolates from episodes of greater than 1 week also bound significantly more Tamm-Horsfall protein than isolates from episodes of less than or equal to 1 week (P = 0.044). Although nearly half of the isolates produced P fimbriae, an important virulence factor for the development of pyelonephritis, no correlation with persistence could be made. Overall, the E. coli isolates expressed traits similar to those of strains that caused cystitis. Type 1 fimbriae appear to be important for the persistence of E. coli in the long-term-catheterized urinary tract.
J Clin Microbiol 1987 Dec
PMID:Expression of type 1 fimbriae may be required for persistence of Escherichia coli in the catheterized urinary tract. 289 55

A variety of genera and species of the family Enterobacteriaceae bear surface fimbriae that enable them to bind to D-mannose residues on eukaryotic cells. Until recently, it was thought that the D-mannose binding site was located in the major structural subunit (FimA), of relative molecular mass (Mr) 17,000 (17 K), of these organelles in Escherichia coli. New evidence indicates that this binding site resides instead in a minor protein Mr 28-31 K (FimH) located at the tips and at long intervals along the length of the fimbriae, and is reminiscent of the minor tip adhesion proteins of pyelonephritis-associated pili (Pap) and S fimbriae. In contrast to the antigenic heterogeneity of the major FimA subunit, the antigenic structure of FimH is conserved among different strains of E. coli. Here, we report an even broader conservation of this minor adhesion protein extending to other genera and species of type 1 fimbriated Enterobacteriaceae. Our results may have implications for the development of broadly protective vaccines against Gram-negative bacillary infections in animals and perhaps in man.
Nature 1988 Dec 15
PMID:Conservation of the D-mannose-adhesion protein among type 1 fimbriated members of the family Enterobacteriaceae. 290 57

This study was designed to analyze the colonizing and invasive properties of wild-type bacteriuric E. coli possessing a variety of phenotypic characteristics in experimental nonobstructive pyelonephritis (P and Type 1 [T] fimbriae, hemolysin [Hly], presence of K capsules, flagella [H], serotype, biotype, human and mouse serumcidal resistance). Special emphasis was on the role of Gal-Gal adhesin (P fimbriae) of non-genetically engineered uroisolates. It was shown that organisms that are P+ or T+ or Hly+ are more likely to colonize bladders than strains negative for those parameters (P less than 0.001). Additionally, P+ strains were more often associated with kidney histopathology than P- E. coli (P less than 0.05). However, the data also indicated that fimbriae (P and Type 1) were not sole determinants of virulence since two strains devoid of fimbriae, hemolysin, K capsules and sensitive to human serumcidal activity caused incipient and acute pyelonephritis. Even among identical serotypes and biotypes, the presence/absence of fimbriae did not appear to be the critical factor in urovirulence, nor did the presence of several positive characteristics (hemolysin, K capsule, flagella, serum resistance) in a given strain enhance uropathogenicity. Therefore, these properties do not need to work together to render an E. coli urovirulent. These phenotypic characters may simply represent associated or serologic markers with the host serving as the dominant determinant of susceptibility to urinary infection. The findings emphasize the inherent limitations in relating and extrapolating colonizing and invasive properties of genetically engineered strains to those of naturally occurring, wild-type E. coli human uroisolates causing pyelonephritis.
Kidney Int 1988 Dec
PMID:Virulence of wild-type E. coli uroisolates in experimental pyelonephritis. 290 97

The clinical activity of piperacillin was evaluated in 34 children (mean age: 8 years) presenting with severe infection (septicaemia, meningitis, bronchopneumonia, pyelonephritis). A bacteriological diagnosis was established in 24 cases. The mean duration of treatment was 11 days, and the mean dose 220 mg/kg/day administered in three injections. In 25 cases piperacillin was combined with another antibiotic, usually an aminoglycoside (20 cases). Clinical cure or improvement was obtained in 29 children (85%). Treatment was well tolerated, with only 2 cases of moderate blood eosinophilia. In view of these results the authors suggest that piperacillin could be used in children in two circumstances: severe infections caused by Gram-negative cocci or bacilli in children with cystic fibrosis or neutropenia, and against infections contracted in intensive care units, or in children with febrile leucopenia, combined with an aminoglycoside in the absence of, or pending bacteriological results.
Presse Med 1986 Dec 20
PMID:[Indications for piperacillin in pediatrics]. 294 80

We report a case of xanthogranulomatous pyelonephritis in a cadaver kidney allograft. The patient had diabetic glomerulosclerosis. The predisposing factors that led to this condition included hyperglycemia, a previous rejection reaction and Escherichia coli urinary infection. Persistent fever, pyuria, bacilluria and a nonfunctioning allograft resulted in allograft nephrectomy. The diagnosis was made on histological examination. Diagnostic criteria for xanthogranulomatous pyelonephritis in the allografted kidney are similar to those in the native kidney.
J Urol 1988 Dec
PMID:Xanthogranulomatous pyelonephritis in a renal allograft. 305 33

Known since 1930, C-reactive protein is, as serum amyloid P component its similar, part of acute phase response proteins. Its principals properties are short half-life (6-8 h), great (within 6 hours) and high (X500) rate after injury. It activates the classical complement pathway, leading further to bacterial opsonization. Different biological methods for measurement are described: both nephelometric laser method, most sensible, and agglutination-latex method, most simple and quickest, are chosen. Studies showed us that CRP value is interesting for diagnosis of bacterial infections: among them neonates infections, peri-partum infections, meningitis, pyelonephritis, pancreatitis or peritonitis. CRP value determination seems to be useful also to hold on with patients who keep infectious peril, as in post chirurgical following, neutropenic induced patients. It seemed to be no use for CRP measurement in grafts following. Its rate in inflammatory diseases or myocardial infarcts is just mentioned. The author precognize more determinations of CRP: in emergency laboratories for diagnosis of bacterial infections (agglutination latex method) and in "routine" to follow up the infectious peril.
Pathol Biol (Paris) 1988 Dec
PMID:[C-reactive protein: general review and role in the study of infections]. 307 Apr 64

Using standard real time sonography, renal cortical echogenicity, renal length, intrarenal cystic structures and renal calculi were evaluated in 63 patients (30 men, 33 women) in end-stage renal parenchymal diseases (glomerulonephritis n = 21, diabetic glomerulosclerosis n = 9, analgesic nephropathy n = 14, chronic atrophic pyelonephritis n = 19). Patients with glomerulonephritis and diabetic glomerulosclerosis presented with larger kidneys and only slightly increased cortical echogenicity as compared to analgesic nephropathy and chronic atrophic pyelonephritis. In addition, intrarenal cystic structures were found in 50% of the patients with analgesic nephropathy and in 31% of the patients with pyelonephritis, compared with only 14% and 11% in patients with glomerulonephritis and diabetic glomerulosclerosis, respectively. Intrarenal calcifications were more frequent in pyelonephritis and analgesic nephropathy. In end-stage renal parenchymal disease, sonography might be able to distinguish between different types of renal medical disorders.
Ultraschall Med 1988 Dec
PMID:[Ultrasound in terminal renal failure--etiologic conclusions?]. 307 Jul 47

Xanthogranulomatous pyelonephritis is a rare disease of the kidney. The pre-operative diagnosis of this disease is usually very difficult. Recently, echo-guided aspiration biopsy has been suggested for the differential diagnosis of the renal mass. We experienced a case of xanthogranulomatous pyelonephritis and performed echo-guided aspiration biopsy. A 57-year-old female was admitted to our hospital with complaints of upper abdominal pain and right lumbago. Judging from the findings obtained by intravenous pyelography, computed tomographic scan, ultrasonography and angiography, the lesion was a right renal inflammatory mass but renal tumor could not be denied. Because clear cell carcinoma was suspected from the results of echo-guided aspiration biopsy, right radical nephrectomy was performed. However, the resected kidney was diagnosed to be xanthogranulomatous pyelonephritis. Post-operative course was uneventful.
Hinyokika Kiyo 1988 Dec
PMID:[A case of xanthogranulomatous pyelonephritis--an experience of echo-guided aspiration biopsy for the diagnosis]. 307 Nov 26

Since 1981, the Korean Society of Nephrology began annual report on renal replacement therapy in Korea. The annual number of new patients receiving dialysis treatment in 1986 increased to 957 patients (23.3 per million population) from 825 patients (20.4 per million population) in 1985. And the total number of patients on replacement therapy increased from 1,508 patients (37.3 per million population) to 2,534 patients (61.7 per million population). 1,340 patients (32.6 per million population) of these patients were on hemodialysis, 573 patients (13.9 per million population) on continuous ambulatory peritoneal dialysis (CAPD) and 621 patients (15.1 per million population) on functioning renal graft as of December 31, 1986. The common causes of renal failure of new patients were chronic glomerulonephritis (41.6%) followed by diabetic nephropathy (12.6%), nypertensive nephrosclerosis (7.8%), chronic pyelonephritis (2.5%) and others. The annual mortality rate decreased from 21.9% in 1981 to 13.5 in 1986. The common causes of death in patients on dialysis therapy were cardiac (32.8%), vascular (14.7%), infective (14.7%) and social problems (11.2%) in the order of frequency. Recently, the number of patients requiring dialysis is rapidly increasing due to expanded medical insurance support for dialysis and improved economic status of our country. Therefore, it is necessary to draw up counterplan for a rapid growth of the number of new patients.
J Korean Med Sci 1988 Dec
PMID:Multicenter report on dialysis and transplantation in Korea, 1986. Korean Society of Nephrology. 307 56

The therapeutic activities of orally administered FK482 were compared with those of reference antibiotics against systemic and local infections with a variety of bacteria in mice and rabbits. In systemic infections in mice, oral FK482 was almost as effective as oral cefaclor (CCL) and more effective than oral cephalexin (CEX) against Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis infections. However, FK482 afforded superior protective activity when given subcutaneously against E. coli infection in mice, and this activity was more potent than that of subcutaneously given CCL. In comparison with CCL, the reason that the in vivo activity of orally given FK482 against mouse systemic infections was weaker than had been anticipated from its potent in vitro activity was due to its poor oral absorption in mice. In local infections in rabbits, a species in which FK482 was better absorbed than in mice, FK482 was more effective than CCL, CEX or amoxicillin (AMPC). Against pneumonia induced by S. aureus or Streptococcus pyogenes, FK482 was as effective as AMPC and more effective than CCL in reducing the number of viable bacteria in the lungs of infected rabbits. In the oral treatment of experimental ascending pyelonephritis in rabbits, FK482 was superior to CCL and AMPC against methicillin-resistant S. aureus infection, as effective as AMPC and more effective than CCL against Enterococcus faecalis infection, and as effective as cefixime (CFIX) and more effective than CCL and AMPC against E. coli infection in reducing the number of viable bacteria in the kidneys and urine.
J Antibiot (Tokyo) 1988 Dec
PMID:In vivo antibacterial activity of FK482, a new orally active cephalosporin. 320 80


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