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[Antibodies to Yersinia enterocolitica and Proteus mirabilis in blood sera of rheumatoid arthritis patients].

Data on specific antibodies to the bacterial antigens of Yersinia enterocolitica (serovars 03, 09) and Proteus mirabilis in rheumatoid arthritis (RA) patients are presented. According to the data of some researchers, these organisms play some role in the pathogenesis of RA. The highest level of IgG antibodies to Y. enterocolitica antigens of both serovars was noted. The activity of specific IgG antibodies to serovar 03 was higher than that to serovar 09. In the sera of RA patients with P. mirabilis antgens the activity of IgM antibodies was higher.

Antibodies, Bacterial↗

[Proteus septicemias. Apropos of 4 cases].

The authors record four cases of septicemia caused by Proteus, observed at the "Hôpital Girard et Robic" resuscitation department, in Tananarive, Madagascar. The patients were young and free from visceral disorders. The first case was a post-abortum etiology with a myocardial clinical picture. The second case also was a post-abortum etiology. The course led to the septic shock and to the death. The starting point of the third case was the urinary system, following upon the removal of an urinary obstruction due to post-operative anuresis. In the fourth case, the focus was urinary with a pulmonary clinical picture. The course led to the septic shock and to the death. In all instances, the germ showed sensitivity to amikacin and to the third-generation cephalosporins. The clinical course that led to the septic shock had deeply entailed the prognosis of these septicemias.

Abortion, Septic↗

Lens implant cyto-pathology in postoperative Proteus panophthalmitis.

The reactive membrane on a posterior chamber lens implant removed from an eye with postoperative proteus mirabilis panophthalmitis was found to be based on a continuous proteinaceous capsule exhibiting only very few fibroblast-like cells. Diffusely arranged neutrophils exhibiting evidence of phagocytosis were attached to a delicate fiber network continuous with the processes of fibroblast-like cells. There was also pus and acellular debris loosely covering the outer surface of this capsule.

Aged↗

[The secreted proteolytic enzymes of Proteus mirabilis].

Experiments on white mice, made with the use of genetically linked pair of P. mirabilis differing in the presence of protease activity, have demonstrated the role of this activity in the aggravation of the infectious process, observed only in cases of the parenteral introduction of microorganisms. The damaging action of proteases manifests by decreased antiprotease capacity of the blood and the dissemination of bacteria into organs and tissues with the predominant colonization of the urinary tract. The damage of the epithelial barrier of the gastrointestinal mucosa after the intragastric administration of bacteria can be observed after preliminary destruction of the protective layer consisting of mucin and containing sIgA.

Animals↗

[Hyperammonemia in hydronephrosis].

A man aged 81 with bilateral hydronephrosis presented with lethargy deepening into coma caused by hyperammonaemia. The hyperammonaemia was most likely caused by excessive absorption of ammonia produced by Proteus mirabilis in the obstructed and dilated urinary tract. The patient died within a few hours.

Aged↗

Ten years' experience in general practice of dip-slide urine culture in children under five years old.

Of 567 children under five registered with an industrial general practice over a 10-year period, 559 presented with symptoms of ill health in the first five years of life, and of these, 158 (27.9 per cent of those registered) had urine cultured using the dip-slide method. Thirty-four (12.3 per cent) girls and 23 (7.9 per cent) boys had at least one episode of significant bacteriuria. Two boys and three girls were found to have radiological abnormalities of the genito-urinary tract, of which two were obstructive lesions requiring surgery.Symptoms usually ascribed to the urinary tract in older children and adults did not discriminate for infection in this age group and were not a reliable indicator of the presence, or of the absence, of significant bacteriuria.The incidence of significant bacteriuria was considerably above that recorded by surveys on asymptomatic children. Proteus infections were four times more common among boys than girls, and under the age of three the proportion of boys with bacteriuria exceeded that of girls.Dip-slide culture is a valuable tool in the diagnosis, management, and follow-up of urinary tract infection.

Bacteriological Techniques↗

Effect of organic mercurials and sulfhydryl compounds on the urease activity of Proteus: inhibition by urine and ascorbic acid.

Meralluride, mercaptomerin, ethacrynic acid, and penicillamine inhibited urease activity of Proteus mirabilis. The activity of the organic mercurials and ethacrynic acid was markedly inhibited by human and dog urine. Antiurease activity could not be detected in the urine of a human and a dog given meralluride by injection. Urine from patients receiving penicillamine also failed to inhibit urease activity. Ascorbic acid inhibited, whereas dehydroascorbic acid enhanced, the activity of the mercurials, but neither agent altered the inhibitory effect of urine. The lethal effect of meralluride against Proteus occurred at the same concentration at which urease activity was inhibited, but penicillamine inhibited the enzymatic activity without affecting viability of the organism. The data suggest that these sulfhydryl-reactive compounds will not be useful against Proteus infections of the urinary tract.

Animals↗

[Synergism of colistin and sulfonamide in proteus species (author's transl)].

In agar diffusion testing of Proteus mirabilis strains sensitive to sulfonamide a synergistic effect of colistine (C) and sulfonamide (S) was demonstrated. By quantitative evaluation these results were confirmed in 100 strains of Proteus mirabilis and 100 strains of indol-positive Proteus spp. using broth dilution method. Combining 1 part C with 10 parts S the mean increase in sulfonamide sensitivity was enhanced fourfold. Increasing the inoculum sensitivity of Proteus against the combination of C and S was still found to range within therapeutic blood levels. Therefore in treatment of Proteus infection the positive synergistic effect of C+S should be taken into consideration.

Colistin↗

Cushing's syndrome--transitory immune deficiency state?

A 28 year old female patient with Cushing's syndrome due to an adrenal adenoma also suffered from recurrent urinary infections (proteus), tonsillitis (streptococcus), permanent candidiasis and perimandibular abscess (Staphylococcus pyogenes). Suppression of cellular and humoral immunity was confirmed by in vitro tests. After successful right adrenalectomy the clinical signs of Cushing's syndrome disappeared and no evidence of either bacterial or fungal infection were noted one year postoperatively. Immunological tests showed the restitution of both cellular and humoral immunity. The course of the disease in the patient supports the idea that Cushing's syndrome might be considered as a transitory immune deficiency state.

Adenoma↗

[The detection of a choleriform thermolabile enterotoxin in clinical strains of Proteus isolated in different infections].

The capacity of Proteus strains, isolated from patients with purulent inflammatory, urological and enteric infections, for the production of choleriform thermolabile enterotoxin was studied by means of the enzyme immunoassay (EIA) with the use of antitoxic serum to Escherichia coli enterotoxin. Out of 125 strains, 27 (21.6%) showed the capacity for producing choleriform thermolabile enterotoxin in EIA experiments. The results thus obtained indicate that EIA techniques can be used, in principle, for detecting the capacity of Proteus for the production of choleriform thermolabile enterotoxin.

Acute Disease↗

Use of an electronic nose system for diagnoses of urinary tract infections.

The use of volatile production patterns produced by bacterial contaminants in urine samples were examined using electronic nose technology. In two experiments 25 and 45 samples from patients were analysed for specific bacterial contaminants using agar culture techniques and the major UTI bacterial species identified. These samples were also analysed by incubation in a volatile generation test tube system for 4-5 h. The volatile production patterns were then analysed using an electronic nose system with 14 conducting polymer sensors. In the first experiment analysis of the data using a neural network (NN) enabled identification of all but one of the samples correctly when compared to the culture information. Four groups could be distinguished, i.e. normal urine, Escherichia coli infected, Proteus spp. and Staphylococcus spp. In the second experiment it was again possible to use NN systems to examine the volatile production patterns and identify 18 of 19 unknown UTI cases. Only one normal patient sample was mis-identified as an E. coli infected sample. Discriminant function analysis also differentiated between normal urine samples, that infected with E. coli and with Staphylococcus spp. This study has shown the potential for early detection of microbial contaminants in urine samples using electronic nose technology for the first time. These findings will have implications for the development of rapid systems for use in clinical practice.

Biosensing Techniques↗

Symptomatic urinary infection in childhood: presentation during a four-year study in general practice and significance and outcome at seven years.

Thirty-eight children (12 boys and 26 girls) with symptomatic urinary infection have been studied in general practice. Patients were collected over a four-year period and we report an incidence of urinary infection according to Kass's criterion of 7.7 per 1,000 girls at risk per year and 3.8 per 1,000 boys at risk per year. Eighty-four per cent of the children had symptoms which suggested an origin in the genitourinary tract. Proteus infection was found in five of the boys and only one of the girls. At the end of the four-year study period follow-up had taken place over a mean period of 25 months and recurrent infection had been demonstrated in four boys and 12 girls. All the children had an excretion urogram and two children, both girls, were found to have pyelonephritic scarring. Twelve children with recurrent infection were investigated for vesicoureteric reflux, which was found only in the two children with scarring. At seven years 31 of the children remained in the practice and, with a mean follow-up of 42 months, no significant alteration in the figures for recurrent infection was demonstrated. Guidelines are suggested for the management of childhood urinary infection in general practice.

Adolescent↗

Comparative in vitro encrustation studies of biomaterials in human urine.

A new dynamic in vitro human urine model was developed to compare biomaterial encrustation. The model incorporates a capacity to study seven biomaterials, a daily urine inflow of 500 ml, a reservoir capacity of 700 ml, and a turnover rate of four days. Encrustation studies performed for 2 weeks in sterile and infected (Proteus Vulgaris) urine on segmented polyether polyurethane, polyester polyurethane, silicone (Mitsui), silicone (Dow Corning), biothane, biolor 1 and biolor 11 demonstrated that biolor 11 (silicone-carbon composite) caused the least encrustation. Encrustation analysis showed brushite in the sterile model and struvite and ammonium acid urate in the infected mode I. Biolor II should have beneficial applications in catheters, stents and prosthetics which come in contact with urine.

Bacteriuria↗