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At least 199 records · Page 11Linked to original sources
PubMed1976

Urease. The primary cause of infection-induced urinary stones.

Previous reports have suggested that urease-producing bacteria play a prominent role in the formation of infection-induced urinary stones. We have carried out crystalization experiments in vitro which show that bacterial urease alkalinizes urine, thereby causing: (i) supersaturation with respect to struvite and calcium phosphate; and (ii) formation of struvite and apatite crystals. Growth of Proteus in urea-free urine or in urine which contained a urease inhibitor did not cause alkalinization, supersaturation, or crystallization of struvite and apatite. Growth of Klebsiella, Escherichia coli, or Pseudomonas was not associated with significant alkalinization, supersaturation, or crystallization. Struvite and apatite crystals dissolved in Proteus-infected urine in which undersaturation was maintained by urease inhibition. Similar results in all experiments were obtained using human urine and a synthetic urine which was devoid of matrix, pyrophosphate, or other undefined solutes. Urease-induced supersaturation appears to be the primary cause of infection-induced urinary stones.

Bacteria↗
PubMed2002

Pathological and therapeutic significance of cellular invasion by Proteus mirabilis in an enterocystoplasty infection stone model.

Proteus mirabilis infection often leads to stone formation. We evaluated how bacterium-mucin adhesion, invasion, and intracellular crystal formation are related to antibiotic sensitivity and may cause frequent stone formation in enterocystoplasties. Five intestinal (Caco-2, HT29, HT29-18N2, HT29-FU, and HT29-MTX) and one ureter cell line (SV-HUC-1) were incubated in artificial urine with five Proteus mirabilis strains. Fluorescence-activated cell sorting (FACS), laser scanning microscopy, and electron microscopy evaluated cellular adhesion and/or invasion, pathologic changes to mitochondria, and P. mirabilis-mucin colocalization (MUC2 and MUC5AC). An MTT (thiazolyl blue tetrazolium bromide) assay and FACS analysis of caspase-3 evaluated the cellular response. Infected cells were incubated with antibiotics at dosages representing the expected urinary concentrations in a 10-year-old, 30-kg child to evaluate bacterial invasion and survival. All cell lines showed colocalization of P. mirabilis with human colonic mucin (i.e., MUC2) and human gastric mucin (i.e., MUC5AC). The correlation between membrane mucin expression and invasion was significant and opposite for SV-HUC-1 and HT29-MTX. Microscopically, invasion by P. mirabilis with intracellular crystal formation and mitochondrial damage was found. Double membranes surrounded bacteria in intestinal cells. Relative resistance to cotrimoxazole and augmentin was found in the presence of epithelial cells. Ciprofloxacin and gentamicin remained effective. Membrane mucin expression was correlated with relative antibiotic resistance. Cell invasion by P. mirabilis and mucin- and cell type-related distribution and response differences indicate bacterial tropism that affects crystal formation and mucosal presence. Bacterial invasion seems to have cell type-dependent mechanisms and prolong bacterial survival in antibiotic therapy, giving a new target for therapeutic optimalization of antibiotic treatment.

Anti-Bacterial Agents↗
PubMed1983

[Combined Staphylococcus-Proteus-Pseudomonas vaccine. II. The toxicity of the vaccine in "chronic" experiments and its ability to protect animals against Proteus and Staphylococcus infections].

The combined preparation consisting of the antigenic complexes of staphylococci (1 part), Proteus (1 part) and P. aeruginosa parts) was capable of protecting mice from infection with staphylococci, Proteus and P. aeruginosa and prolonging the survival time of rabbits under the conditions of the development of staphylococcal sepsis. The staphylococcal component of the combined preparation possessed adjuvant activity, increasing the immunogenicity of Proteus antigen. The combined vaccine enhanced a short-time increase in the nonspecific resistance of the animals. The moderate toxicity of the preparation permits making multiple injections of the preparation to mice without inhibiting the weight gain of the animals.

Animals↗
PubMed2005

[Necrotizing fasciitis of the head and neck].

Necrotizing fasciitis (NF) is a potentially lethal soft tissue infection characterized by cutaneous necrosis, suppurative fasciitis, vascular thrombosis and extreme systemic toxicity. It is a rare entity in the head and neck region, but occur most frequently in patients with diabetes and chronic alcoholism. Mostly involved are immunodeficient patients with banal infections of the upper aerodigestive tract, small traumas, but also after surgical procedures. Necrotizing fasciitis is an infection caused by aerobic or anaerobic microorganisms. A strong complication is a streptococcus-associated-toxic shock-syndrome which should be prevented because it is often associated with letal outcome. Septicemia and systemic toxic effects may lead to death within as short a time as 2 to 4 days. Necrotizing fasciitis is often misdiagnosed or the diagnosis is delayed with a mortality rate of approximately 30-70%. Once identified, treatment consists of antimicrobial therapy and surgical debridement followed at a later date with reconstructive surgery. We present a fatal case of craniofacial necrotizing fasciitis (NF) in a 63-year-old diabetic and chronic alcoholic man and discuss it's pathophysiology, clinical manifestations and the best therapeutic choice for this disease. A review of the literature with the clinical presentations, bacteriology diagnosis and treatment was presented.

Candida albicans↗
PubMed1978

[Chemotherapy of experimental lactational mastitis in mice].

More severe mastitis on infection with Proteus was shown on a standardized model of experimental lactation mastitis of mice caused by Staphylococcus, Proteus and their mixture. Significant differences in the morphological pictures of the staphylococcal and Proteus mastitis were noted. A pronounced effect was observed with the use of kanamycin in combination with fuzidin in treatment of experimental mastitis of various etiology.

Animals↗
PubMed2000

Paediatric anatrophic nephrolithotomy; stone clearance - at what price?

OBJECTIVE: To evaluate the functional outcome of anatrophic nephrolithotomy in children. PATIENTS AND METHODS: All children undergoing anatrophic nephrolithotomy for complex branching and multiple renal calculi over an 11-year period were studied prospectively. Demographic data, treatment details and outcome, as assessed by X-ray, ultrasonography and isotope studies, were recorded. Anatrophic nephrolithotomy was carried out with surface cooling of the kidney followed by nephrostomy drainage for 5-7 days. RESULTS: Nine children (median age 4 years, range 7 months to 9 years) underwent anatrophic nephrolithotomy. Predisposing factors included urinary tract infection (by Proteus mirabilis) in all and hyper-calciuria in two children. The median (range) total ischaemic time at operation was 25 (15-40) min and the operative duration 150 (120-200) min. Three children required a blood transfusion. Stone clearance was incomplete in one child. There was no recurrent stone formation after a long-term follow-up (median 32 months, range 14-107) in the other patients. Isotope studies showed impaired split renal function (<40%) in six children before surgery; there was a significant decline (>5%) in divided function in five children (range 6-16%) after surgery. CONCLUSION: Anatrophic nephrolithotomy is an effective means of rendering children with branching calculi stone-free, but this study suggests that it leads to some further parenchymal damage.

Child↗
PubMed1977

Staghorn calculi in children.

Nineteen children who underwent extensive nephrotomies and anatrophic nephrotomies for staghorn calculi (bilateral in 4 cases) are presented. Proteus infection was the cause of the calculus in most cases. In the absence of recurrent stones, renal growth and function were excellent post-operatively. Stone recurrence was minimal if all calculi were removed and infection was controlled. Followup ranged from a few months to 13 years.

Adolescent↗
PubMed2000

Successful in situ treatment of an infected ascending aortic graft.

Infection of an ascending aortic prosthesis is a grave complication associated with a high mortality. In most cases, extraanatomic bypass and removal of the infected vascular graft are not possible. Furthermore, the standard approach to this problem, which includes excision and replacement or debridement and repair of infected thoracic aortic grafts, carries a high early mortality. We report the successful treatment of this life-threatening complication using a conservative strategy in which the aortic prosthesis was salvaged by in situ disinfection followed by coverage with tissue flaps.

Adult↗
PubMed1991

[Long ureteral ammonium-magnesium phosphate (struvite) and calcium phospho-carbonate calculi].

The authors report about 12 cases of long ureteral calculi, 16 to 39 mm in size, observed over 10 years. They were all made of a mixture of ammonium-magnesium phosphate and calcium phosphocarbonate. Infection was the revealing symptom, either in the form of simple bacteriuria or as acute pyelonephritis or sepsis. These calculi, found in a lumbar or pelvic location, were very long, radiopaque but with a moderate radiological density, homogeneous and have regular contours. They were straight, sometimes slightly bent, rarely (one case out of 12) arciform. In 11 of 12 cases, the affected patient was female. In most cases, the urine was infected by Proteus mirabilis. In spite of their size, the calculi caused total obstruction in 3 of 12 cases only. They were or were not associated to ipsilateral coral calculi of the same chemical type. Destruction was easily achieved with physical agents. The etiological, radiological and therapeutic characteristics of these calculi give them a specific place among ammonium-magnesium phosphate calculi.

Adult↗
PubMed1975

The sex variable in childhood urinary-tract infection.

Sex differences in childhood urinary-tract infection have been looked for by reviewing the medical records of all patients who were admitted to one medical centre during a certain time period. There were 240 patients; 26 males and 214 females, all under 14 years of age. The disease in boys-as compared with that in girls-was found to be characterized by an earlier onset, a shorter delay in diagnosis, and a shorter duration; but a higher frequency of malformations, a greater number of rehospitalizations, and a greater need for surgical intervention. Proteus infection was found more frequently in boys, while Enterococcus and Staphylococcus were more frequent in girls. The initial symptomatology did not show any significant sex difference except in late childhood where the non-specific symptoms were more common in females. No sex difference was noted with respect to the frequency of vesico-ureteric reflux or of bacteriuria without pyuria. It seems that the sex variable in this disease is worth considering in dealing with individual patients as well as in presenting data on a series of patients.

Adolescent↗