[The recurring urinary tract infection. Do immunologic factors play a part?].
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Biomedical subjects
Publications and source records attributed to G Riedasch.
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24 patients with renal transplants were studied beyond the immediate postoperative period (greater than 8 weeks p.o.) for a period of 6 months in three weekly intervals. Quantitative bacteriology (dip slide method) and immunofluorescence microscopy (antibody coating of urinary bacteria) of the urine were regularly performed. Urinary tract infection was found in 13 of 24 patients, being permanent in 9 and episodic in 4 of the patients. There was no correlation between presence of urinary tract infection and deterioration of renal function. Mixed infection was found in 7 of the 13 patients and monoinfection in the others. In 7 out of these 13 patients, antibody coating of urinary bacteria could be demonstrated by immunofluorescence microscopy. In 3 of the 7 cases with antibody coating, this was permanently positive, in the other 4 it was intermittently positive. In only 1 case could conversion to positive antibody coating be attributed to urological complications (pyelostomy). Both IGG and IGA were demonstrable in 6 of 7 cases with positive antibody coating and IGG exclusively was demonstrable in 1 more case. IGM was questionably positive in 1 case and complement (beta1C) could not be demonstrated in any of the patients. This investigation shows that despite immunosuppression patients with renal transplants are able to mount an immune response against urinary tract infections.
A prospective study comparing the results of Antibody-Coating-Test (ABC) in semen and aspiration biopsy of the prostate with immunodiffusion of the former was carried out. In 143 patients with clinical signs of prostatitis only 98 showed a positive ABC in their ejaculates. IGA-specific ABC was positive in 75%, IGG-specific ABC in 48%, and IGM-specific ABC in 9.6% respectively. Specimens gained by aspiration biopsy of the prostate were also demonstrating positive ABC. Consistently negative was the ABC in 15 healthy male who served as a control. In 30 patients the ABC-Test of ejaculate speciments was compared with complement (C3) and coeruloplasmin content of the ejaculates using immunodiffusion technique. Contrary to the reports in the literature, however, elevated levels of complement (C3) and coeruloplasmin were not correlated with local infection of the prostate proven by ABC.
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An immunofluorescence technique was used to study antibody coating of bacteria in ejaculates from 14 healthy individuals and 51 patients with complaints compatible with the diagnosis of prostatitis. Quantitative bacteriological cultures in the ejaculate were positive in 2 healthy individuals (14%) and in 25 patients with prostatic symptoms (49%). Antibody-coated bacteria could be demonstrated in 25 patients with prostatic symptoms (49%), 8 of whom had negative bacterial cultures, but in none of the healthy individuals. All 5 patients with epididymitis had antibody-caoted bacteria in the ejaculate. The 13 patients with antibody-coated bacteria in the ejaculate were given antibiotic treatment and the bacteria disappeared in 8 cases. The results document the presence of a (presumably local) immune response in bacterial prostatitis. Antibody coating of bacteria in the ejaculate seems to be helpful in the diagnosis of bacterial prostatitis.