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PubMed1974

Gallium-67 scans in the diagnosis of pyelonephritis.

Gallium-67 ((67)Ga) citrate was administered intravenously (50 microcuries per kg of body weight) to patients in whom acute and chronic urinary tract infections were suspected. Scanning was done, using both the Anger-type scintillation camera and the rectilinear scanner, 24 to 78 hours after injection of the isotope. The preliminary results imply that (67)Ga renal uptake is present in patients with pyelonephritis whether overt or silent, as well as in patients with uretero-sigmoidostomies. However, (67)Ga renal uptake is not present in patients with radiographic evidence of chronic pyelonephritis without active infection and in patients without renal disease.

Acute Disease↗

PubMed1979

Antibody formation in Corynebacterium renale-induced experimental pyelonephritis in the rat.

The immune defense system of the kidney was studied by inducing ascending pyelonephritis in rats with Corynebacterium renale. With the fluorescent antibody technique, C renale organisms were observed in the renal pelvis, but were not coated with antibody until they reached the medulla. Histopathologic evaluation of renal tissues collected serially after inoculation confirmed the presence of infection in the medulla when antibody coating occurred. Serum anti-C renale antibody concentrations increased after antibody-coated bacteria appeared in the urine and kidney. Free anti-C renale antibody was not detected in urine from infected rats, using the microagglutination assay. Antibody coating appears to occur only after C renale organisms invade the medulla during ascending pyelonephritis.

Animals↗

PubMed1977

[Clinical experience with S-6436 in acute pyelonephritis (author's transl)].

S-6436 (a preparation consisting of 30% of non-enteric coated granules and 70% of enteric coated ones) was orally administered to the patients with acute pyelonephritis, and the following results were obtained: 1. Subjective symptoms: Very good in 13 cases (65%), good in 1, fair in 2 and poor in 4. 2. Urine finding: Very good in 13 cases (65%), good in 3 and poor in 4. 3. Disappearance of causative organisms: Organisms which were identified in the first examination were 17 strains of E. coli, one each of Pr. vulgalis, Klebsiella and Staph. epidermidis, 3 of Strept. faecalis, and 3 of mixed infections. Very good effect was observed in 16 cases, good in 1, fair in 1 and poor in 2. 4. Total evaluation: Very good in 13 cases (65%), good in 4 (20%) and poor in 3 (15%). 5. Slight discomfort in abdomen was observed in only one patient, but disappeared by administration of digestive. 6. S-6436 was given to the patients with acute pyelonephritis twice a day expecting that the drug has satisfactory clinical efficacy.

Acute Disease↗

PubMed1977

[Value of antibiotic combination therapy in chronic pyelonephritis--study on a large number of patients over a period of 15 years].

1. 448 patients with chronic pyelonephritis were treated over periods ranging from a minimum of 5 to a maximum of 15 years with our special form of intermittent long-term therapy with chemoprophylaxis in the intervals, the antibiotics - mostly in the form of combinations - and chemotherapeutics in the treatment-phases were always used only on the base of several antibiograms. During the last 11 years synergistic bactericidic combinations of antibiotics were used to an increasing degree. 2. A comparison of the efficacy of our form of therapy used now (since 1965/1966) with the results already published: 1966 (therapy span 1960-1965), 1970 (therapy span 1960-1969), and 1972 (therapy span 1960-1971) showed the following quotes of a transmission into a standstill (questionable healing) of the disease: 1966 (without periodic change of the urinary pH) 36,1% 1966 (with periodic change of the urinary pH) 69,4% 1970 (synergistic combinations of antibiotics) 68,3% 1972 (synergistic combinations of antibiotics) 78,7% 1976 (synergistic combinations of antibiotics) 82,1%. 3. On the basis of our results we consider the combinations of synergistic bactericidic antibiotics as a real enrichment of the therapy of chronic pyelonephritis.

Anti-Bacterial Agents↗

PubMed1980

[Microbiological aspects of human pyelonephritis].

Issuing from the adhesive ability of bacteria to human mucous membranes the phenomenon of the adhesion of E. coli to uroepithelial cells is analysed in detail. Fimbrias and colonisation factors might be of importance. In own experiments the first clues concerning the numberous appearance of these adhesive factors could be got. In further investigations the author adopts a definite attitude to the problems of the rough forms of E. coli as the pathogenic agent of a pyelonephritis of man. It is to be assumed that by the occurrence of certain factors of virulence rough forms possess importance as causal agents of pyelonephritis.

Adhesiveness↗

PubMed1982

O, K, H and fimbrial antigens in Escherichia coli serotypes associated with pyelonephritis and cystitis.

O:K:H serotype determination of 267 E. coli strains from patients with pyelonephritis or cystitis led us to tentatively consider some O:K:H types, e.g. O6:K2:H1 as pyelonephritis and e.g. O6:K13:H1 as cystitis associated types. By means of crossed immunoelectrophoresis (CIE) several strains of such special O:K:H serotypes were examined for presence of the previously described fimbrial antigens, F7 and F8. Three new F antigens were designated F10, F11 and F12. The fimbrial structures of these antigens were demonstrated by immunoelectron microscopy (IEM). Based on the haemagglutinating (HA) capacity of the strains it was possible to separate differently fimbriated organisms of the same strain. The bacteria which agglutinate human erythrocytes could be absorbed out of the mixture when the erythrocytes were removed by sedimentation. When the bacteria in the supernatant no longer agglutinated human erythrocytes they were regarded as HA absorbed and were compared with non-HA absorbed bacteria for their ability to attach to epithelial cells from the urinary tract. Hence, it was concluded that F7, F8 and F10 caused haemagglutination and were responsible for the attachment to urinary epithelial cells, while the fimbriae antigenically termed pseudotype 1 did not induce haemagglutination and played little or no role for the attachment to this kind of epithelial cells.

Adhesins, Escherichia coli↗

PubMed1984

[Escherichia coli with the K1 antigen isolated in pyelonephritis in children].

The identification of K antigens in 113 E. coli strains isolated from the urine of 62 pyelonephritis patients was carried out. 84 strains were found to possess K antigens. The presence of K antigens was revealed in strains both in the S-form (67 cultures) and in the R-form (17 cultures). Among the strains with K antigens the presence of K1 antigen was revealed in 41.7 +/- 6.5% of cases. K1 antigen was found in combination with eight groups of O antigens (01, 02, 04, 017, 018, 050, 077, 0141) and with R antigens. The above-mentioned E. coli strains were isolated from 16 patients; of these, 3 patients had chronic pyelonephritis.

Adolescent↗

PubMed1980

[Chronic pyelonephritis from a clinical viewpoint].

The chronic pyelonephritis is an unspecific, bacterial, focal, interstitial nephritis with faculative participation of the pyelon. It is differentiated between an obstructive (secondary) and non-obstructive (primary) form. It is referred to the importance of risk factors and risk groups deriving themselves from this. Without doubt, the chronic pyelonephritis is the most frequent renal disease which is confirmed by new statistics of morbidity. The diagnostics still renders difficulties. In a course poor in symptoms it is not thought of the existence of the disease. For the rational dignostics in practice a step plan is recommended. In every case diagnostics should precede therapy. A therapeutic nihilism is to be avoided. A schematic treatment used without criticism and without taking into consideration individual peculiarities, secondary diseases, pregnancy and so on is to be abandoned. Short-term therapy and long-term prevention must be tuned one to another and possibly rationally combined. A plan for the long-term control in the renal dispensary is proposed.

Aftercare↗

PubMed1981

Immunology of pyelonephritis in the primate model. II. Effect on immunosuppression.

Nonobstructive pyelonephritis was produced in the rhesus monkey (Macaca mulatta) by means of retrograde inoculation of Escherichia coli to the point of pyelotubular backflow. The effects of treatment with cyclophosphamide or azathioprine were determined. Commensal renal viruses were not activated by the immunosuppression, and thus did not complicate our results. Both cyclophosphamide and azathioprine prolonged the bacteriuria and produced more severe pathology. Cyclophosphamide decreased the leukocytic response and partically suppressed the antibody response. The increased amount of acute pyelonecytic response and partially suppressed the antibody response. The increased amount of acute pyelonephritic lesions after treatment with this drug suggest that the antibody and inflammatory responses may be important protective mechanisms, particularly regarding prevention of abscesses. In contrast, azathioprine did not decrease the leukocytosis nor the antibody responses, but resulted in decreased in vitro responsiveness of lymphocytes to mitogens. The increased severity of chronic pyelonephritic lesions after azathioprine treatment suggests that the cellular immune response also may be an important protective mechanism during late stages of the disease. The results thus indicate that the immune response is protective and is not directly responsible for the chronic scarring of pyelonephritis.

Animals↗

PubMed1984

[Serum resistance of Escherichia coli and serum bactericidal activity in chronic pyelonephritis].

123 patients with chronic pyelonephritis of the renal dispensary of the clinic of internal medicine of the Department of Medicine Wilhelm Pieck University Rostock were controlled microbiologically for one to four years. Of 59 patients of this group with significant bacteriuria we cultivated 170 strains of E. coli, which were standardised O, K, and H. Of all causative organisms the serum resistance was determined in a human serum pool. All sera of patients were examined for their bactericidal activity to the homologous E. coli urine strain as well as to a serum-sensitive E. coli reference strain (E. coli O 22:K-:H+). In 11.8% we found in the sera investigated at the time of the excretion of causative organisms disturbances of the serum bactericidal action, which rendered possible the survival of the sensitive in the human serum pool causative organism. In 8.82% of the sera of patients at the time of bacteriuria there was a decreased bactericidal action against the E. coli reference strain, only two of these sera did also not kill the urine strain of the patients. In individual cases sera of patients were examined for bactericidal activity with the homologous germ after absorption. By this absorption the antibactericidal activity of the sera could be removed. The proof of a disturbance of a bactericidal action may be an important reference for the course of the chronic pyelonephritis.

Blood Bactericidal Activity↗

PubMed1984

Massive proteinuria in patients with chronic pyelonephritis.

Massive proteinuria associated with chronic pyelonephritis is reported in five patients. Two of them were known to have vesicoureteral reflux, whereas three had minor predisposing factors only. None of the patients were in severe renal failure or suffered from severe hypertension at the time of massive proteinuria. Results of histological examinations were compatible with a diagnosis of chronic pyelonephritis. Electron microscopy and immunological studies did not show any primary glomerular lesions.

Adult↗

PubMed1984

[Antibacterial therapy of pyelonephritis in pregnant women].

To determine the optimal schemes of rational antibacterial therapy of pyelonephritis gravidarum with ampicillin and cephuroxim, assays of the patient urine and studies on the pharmacokinetics of the drugs were performed. The bacteriurea levels were estimated in 264 women with Gould's method in modification of Ryabinsky and Rodoman. The causative agents of the disease were isolated from the urine of 92 pregnant women. Sensitivity of the isolates to 9 antibiotics was tested with the use of standard paper disks and the method of serial dilutions in solid media. The pharmacokinetics of ampicillin and cephuroxim in the blood and urine of 97 patients was studied for 6-8 hours after parenteral administration of the antibiotics in doses of 500 mg. Comparative analysis of the pharmacokinetic parameters of the antibiotics in the blood and urine of the patients, the antibiotic MICs for the disease causative agents and the clinical course of the disease suggests that pyelonephritis gravidarum should be treated with ampicillin and cephuroxim on doses of 500 mg injected intramuscularly 4 and 3 times a day respectively for 7-8 days in combination with antiinflammatory therapy.

Ampicillin↗

PubMed1984

[Changes in the indicators of the fibrinolytic and kallikrein-kinin systems in patients with calculous pyelonephritis].

A total of 48 patients with calculous pyelonephritis were examined before and after surgery. A study was made of the fibrinolytic system (according to the status of XIIa kallikrein-dependent fibrinolysis, lysis of the plasma clots and euglobulin lysis) and of the kallikrein-kinin system of the plasma (according to kallikrein activity, kininogen content, kininase activity, spontaneous esterase activity and prekallikrein content). The patients with calculos pyelonephritis demonstrated KKS activation and fibrinolysis reduction related to both the lowering of the activator levels and elevation of antiplasmin levels, which in turn created the risk of thrombophilia in this group of patients.

Adult↗

PubMed1983

[Characteristics of the distribution of long-acting sulfanilamides in purulent pyelonephritis in rats].

Distribution of sulfalen, sulfadimethoxine and sulfamethoxypyridazine in the blood and organs of rats and binding of the drugs to the blood serum proteins of the animals with experimental P. aeruginosa pyelonephritis were studied. It was shown that in rats with P. aeruginosa pyelonephritis the levels of long-acting sulfanilamides in the blood and organs were lower, while the levels of their penetration through the histohematic barriers were higher, which was partially due to the decreased binding of sulfanilamides to blood proteins.

Animals↗

PubMed1984

[Acute experimental pyelonephritis. Treatment with tobramycin. Influence of the rhythm of administration on efficacy and renal tolerability].

Acute experimental pyelonephritis was produced in rabbits by injecting E. coli (tobramycin MIC 1 mg/l) into the left kidney and temporarily obstructing the ureter. Animals were given 10 mg/kg tobramycin intramuscularly 48 h after surgery and subsequently every day for 7, 10 or 15 days, either in a single daily dose or in three divided doses at 8 h intervals. Animals were killed 24 h after the last injection. Comparison of results shows that kidneys were sterilized by a single daily dose but not by three divided daily doses. In rabbits given the single daily dose regimen, kidneys recovered a normal macroscopical and histological aspect, serum anti-E. coli antibodies rose more slowly and less significantly, serum creatinine increased less, and renal enzymatic activities were restored (alanine aminopeptidase and N-acetyl-beta-D-glucosaminidase). These findings suggest better efficacy and renal tolerance of the single daily dose regimen as compared to the three daily divided dose regimen in the treatment of acute experimental pyelonephritis.

Animals↗

PubMed1982

[Bacterial spectrum and pathogen resistance in chronic primary and secondary pyelonephritis].

The analysis of 168 patients with chronic infections of the urinary tract served to clarify whether different findings are obtained concerning the spectrum of germs and resistance in cases of primary, secondary monoinfected and secondary superinfected pyelonephritis. It was found that in cases of secondary obstructive pyelonephritis the degree of chemotherapeutic sensitivity is reduced and especially where problem germs (proteus, pseudomonas, Klebsiella) are concerned therapy will hardly be successful except by means of aminoglycosides. In this context the recognition and senitation of multifactorial urological primary diseases which cause infection are of special importance.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Xanthogranulomathous pyelonephritis (and cystic dysplasia) in a newborn].

The authors present a case of diffuse xanthogranulomatous pyelonephritis in a new-born baby which, according to the literature reviewed, is the youngest case reported throughout the world. They stress the coexistence of two facts not mentioned in the cases reviewed: --Segmentary cystic dysplasia.--Xanthogranulomatous disorder in the suprarenal gland. It is also interesting due to the presence of chronic contralateral pyelonephritis. They comment upon the special features of the etiopathogeny, anatomopathology, clinical picture, diagnosis and treatment of this rare disorder.

Child, Preschool↗

PubMedDate not supplied

Experimental retrograde pyelonephritis due to group D streptococcus in the rabbit: pathologic, bacteriologic and antibody-coated bacteria studies.

An experimental model of retrograde pyelonephritis in the rabbit using streptococcus D is described. The pathological findings were those of chronic pyelonephritis. The results of the antibody-coated bacteria test (ACB test) were usually negative at the end of follow-up time. Confirming previous results in streptococcus D urinary infection in the child, this experimental model shows that the ACB test is not reliable in urinary infections due to streptococcus D.

Animals↗