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V L Thomas

Publications and source records attributed to V L Thomas.

49 records · Page 3Linked to original sources
PubMed1981

Bacteria-specific antibody in the urine of patients with acute pyelonephritis and cystitis.

Urine specimens from 65 adult patients with symptomatic urinary tract infections that involved 91 episodes of well-defined acute pyelonephritis or cystitis were tested for antibody-coated bacteria (ACB) by a fluorescent antibody assay, unbound bacteria-specific antibody by radioimmunoassay (RIA), and levels of total protein and IgG. Acute pyelonephritis was associated with positive tests for ACB (22 [69%] of 32), elevated levels of unbound antibody (28 [88%] of 32), and a mean RIA binding ratio of 9.4. Cystitis was associated with negative tests for ACB (56 [95%] of 59), low levels of antibody in urine (38 [64%] of 59), and a mean RIA binding ratio of 3.2. The results showed that a negative test for ACB may occur with elevated levels of unbound antibody in the urine because, although elevated, levels were still too low to result in detectable antibody coating of the bacteria. There was often, but not always, a correlation between RIA binding ratios and levels of urinary protein and IgG.

Acute Disease↗
PubMed1981

Hemagglutination of human type O erythrocytes, hemolysin production, and serogrouping of Escherichia coli isolates from patients with acute pyelonephritis, cystitis, and asymptomatic bacteriuria.

The purpose of this investigation was to study potential virulence factors associated with Escherichia coli urinary pathogens isolated from patients with urinary tract infection. These factors were compared with characteristics of normal-flora E. coli isolated from stool specimens of healthy individuals without a history of urinary tract infection. The potential virulence factor focused on in this study was hemagglutination (HA) of human type O erythrocytes by E. coli urinary pathogens. A total of 265 strains of E. coli isolated from patients with urinary tract infections were tested for their ability to hemagglutinate human type O erythrocytes; of these, 148 (56%) were HA positive. Only 6 of 36 fecal E. coli strains (17%) isolated from healthy controls were HA positive. This significant association of the presence of hemagglutinin on E. coli that causes urinary tract infections indicates the likelihood that HA is a marker of virulence. Only 12% (5 of 43) of Proteus mirabilis and 3% (3 of 104) of Klebsiella pneumoniae urinary isolates were HA positive. There was a trend for HA-positive E. coli to be isolated from patients with kidney infections and positive tests for antibody-coated bacteria rather than bladder infections and negative tests for antibody-coated bacteria, although the difference was not statistically significant. There was a significant correlation (P < 0.025) between hemolysin production and HA; 67% (69 of 103) of the isolates that produced hemolysin also hemagglutinated human type O erythrocytes. There was no significant correlation between HA and motility, although there was a trend for flagellated organisms to be non-hemagglutinators. There was a marked correlation between the presence of hemagglutinin and the serogroup of the E. coli isolate; serogroups O4, O7, and O50 were almost always HA positive (57 of 63; 90%). In contrast, serogroups O8 and O25 were rarely HA positive (2 of 30; 7%).

ABO Blood-Group System↗
PubMed1978

A comparison of two indirect methods for localizing the site of urinary infection: beta glucuronidase levels and the presence of antibody-coated bacteria.

A comparison of two of the indirect methods used for localization of the site of urinary tract infection was made for 218 obstetric patients. There was no correlation between urinary beta glucuronidase activity and the presence of a positive fluorescent antibody test. The ranges of beta glucuronidase activity were so variable that this test could not differentiate between the presence of renal, bladder, or absence of infection.

Bacteria↗
PubMed1978

Immune response in urinary tract infection determined by radioimmunoassay and immunofluorescence: serum antibody levels against infecting bacterium and Enterobacteriaceae common antigen.

A solid-phase radioimmunoassay (RIA) procedure was compared with the indirect fluorescent antibody (IFA) test in a serological study of 76 female adults with urinary tract infections. Relative serum antibody activity was determined against patients' homologous infecting enterobacteria by RIA and IFA and against heterologous enterobacterial common antigen (Escherichia coli O14) by RIA. There was marked correlation between results of the IFA and RIA methods using the homologous system; 22 of 51 patients (43%) with pyelonephritis had significantly elevated serum antibody activity by both IFA (titers greater than or equal to 512) and RIA (binding ratio greater than or equal to 2.0) when compared with normal serum controls; three had significant antibody activity detectable by RIA only. Eighteen (72%) of 25 patients with pyelonephritis had RIA binding ratios of greater than or equal to 2.0 against their homologous bacterial isolates and the enterobacterial common antigen; an additional 6 patients had binding ratios of greater than or equal to 2.0 against the antigen only. All 25 patients with cystitis had low serum antibody levels by IFA and RIA when tested against their own isolate as well as enterobacterial common antigen. The RIA procedure was objective, quantitative, and less tedious to perform than IFA.

Adult↗
PubMed1977

Postpartum surveillance for urinary tract infection: patients at risk of developing pyelonephritis after catheterization.

Asymptomatic postpartum bacteriuria occurred in ten of 354 patients not catheterized (2.8%) and in 19 of 313 patients who were catheterized (6.1%). Obstetric lacterations were commonly associated with bacteriuric patients who were not catheterized. Primigravidas as a total group were more likely to have significant bacteriuria. Nine of 23 patients with urinary retention (39.1%), requiring catheterization for longer than 24 hours, developed asymptomatic bacteriuria; urinary tract infection tended to be progressive in these patients, ascending from lower to upper urinary tract involvement. Using the fluorescent antibody (FA) test, antibody-coated bacteria were demonstrated in specimens from five of these nine patients (56%), indicating silent renal infection.

Antibodies, Bacterial↗
PubMed1976

Asymptomatic bacteriuria in pregnancy: antibody-coated bacteria, renal function, and intrauterine growth retardation.

Asymptomatic bacteriuria (greater than 100,000 microorganisms per milliliter) was found in 70 of 1,400 pregnant women without symptoms referable to the urinary tract (five per cent). With the fluorescent antibody (FA) tests, antibody-coated bacteria were demonstrated in specimens from 35 patients (50 per cent), indicating silent renal bacteriuria. Although confirmation by direct localization methods was not feasible in this group of patients, indirect evidence of renal function impairment associated with the presence of antibody-coated bacteria was suggested by results of the serum creatinine and creatinine clearance tests. The outcome of the pregnancy was compared for patients with bacteriuria (FA-negative or FA-positive tests). An association between the presence of asymptomatic renal bacteriuria and intrauterine growth retardation was noted. Thus, the patient with asymptomatic bacteriuria and a positive FA test is at greater risk of delivering an intrauterine growth-retarded infant.

Bacteriuria↗
PubMed1975

Antibody-coated bacteria in the urine of obstetrical patients with acute pyelonephritis.

The direct immunofluorescence method for the detection of antibody-coated bacteria in urine sediments was used to test urine samples from obstetrical patients with the clinical diagnosis of acute pyelonephritis or cystitis. Antibody-coated bacteria were present in the urine from 12 of 15 patients with acute pyelonephritis, but they were not observed in the urine from 13 patients with cystitis. The clases of antibody coating the bacteria were IgG, IgA, and, in some cases, IgM. A correlation between a high titer of antibody in serum and the presence of antibody-coated bacteria in the urine was noted. These results confirm that the immunofluorescence test can be useful, as previously reported, in distinguishing infection of the kidney from infection of the bladder.

Adolescent↗
PubMed1975

Immunoglobulin levels and antibody-coated bacteria in urines from patients with urinary tract infections.

The presence of antibody-coated bacteria in urines from patients with urinary tract infections has previously been reported to correlate with renal infection as opposed to bladder infection. Urine specimens from 12 patients with pyelonephritis and 12 patients with cystitis were studied to determine whether the antibody coating the bacteria is associated with elevated urine levels of total protein or of particular classes of immunoglobulins. The classes of antibody bound to the infecting bacteria in urines from the patients with pyelonephritis were compared to the levels of unbound antibody in the urine. Each specimen was found to contain antibody-coated bacteria, but not all of the specimens had elevated levels of total protein or immunoglobulins. Thus, the occurrence of antibody-coated bacteria in pyelonephritis did not depend on marked elevations of total urinary protein or immunoglobulins. Studies of patients with cystitis showed that immunoglobulins and protein present in the urines, even in elevated quantities, did not react with the infecting bacteria in patients with bladder infections, as each of these patients had negative FA tests for antibody-coated bacteria.

Antibodies, Bacterial↗
PubMedDate not supplied

The treatment of urinary tract infections in women with diabetes mellitus.

Forty-five women with diabetes mellitus and urinary tract infections have been followed an average of 34 mo on treatment protocols based on localization of infection as determined by the presence or absence of antibody-coated bacteria (ACB). Treatment was usually, but not exclusively, trimethoprim-sulfamethoxazole. Two weeks of oral therapy was equally efficacious to 6 wk of treatment in asymptomatic women with antibody-coated bacteria (ACB)-positive infection in eradicating bacteriuria. Recurrences in all groups were predominantly reinfections with differing serotypes or species of microorganisms. The sustained remission rate (fractional extraction) after initial treatment was similar to other reported groups, but possibly less efficacious with recurrences. Suppressive therapy with trimethoprim-sulfamethoxazole for repeated recurrences effectively prevented infection but provided no posttreatment benefit. A high prevalence of underlying structural genitourinary tract abnormalities, usually detectable on pelvic examination, and which were not direct consequences of diabetes mellitus, were possible contributing factors to recurrent infection in this patient group. Progressive elevation in serum creatinine in seven patients with initial ACB-positive infections appeared to relate more closely to diabetic nephropathy rather than chronic pyelonephritis. ACB-positivity correlated well with elevated serum antibody titers and the presence of underlying anatomic abnormalities, but ACB categorization did not lead to improved therapeutic strategy or outcome and hence was of limited clinical usefulness.

Adult↗