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At least 19 recordsLinked to original sources
PubMed1977

Immunization against retrograde pyelonephritis. III. Vaccination against chronic pyelonephritis due to Escherichia coli.

Vaccination with formalin-treated cells of Escherichia coli serotype O6 protected against unilateral retrograde pyelonephritis due to E. coli O6 in rats with partial ureteral obstruction. This protection was manifested not only by less parenchymal destruction and shrinkage of the pyelonephritic left kidney, but also by less secondary pyelonephritis and compensatory hypertrophy in the opposite right kidney. Vaccinated rats eliminated E. coli from the kidney more rapidly, but even when infection persisted in the kidney, the chronic pyelonephritis was less severe in vaccinated rats. High levels of antibody to E. coli lipopolysaccharide were found in vaccinated animals and may have contributed to protection. These results raise the question of whether vaccination ought to be considered for patients predisposed to chronic bacterial pyelonephritis.

Animals↗
PubMed1978

Experimental pyelonephritis. V. Functional characteristics of pyelonephritis.

Changes in renal and ureteral function were studied in monkeys with experimental pyelonephritis, and correlated with the findings of 131I Hippuran scintiphotos. During the acute phase, delayed excretion of radionuclide was found to be a combined result of prolonged intrarenal as well as ureteral transit times. During the chronic phase, scintiphoto studies revealed decreased renal uptake of radionuclide suggesting decreased renal blood flow. Subsequent individual renal function studies confirmed the decrease in renal function and provided data that strongly support the "intact nephron hypothesis" in chronic pyelonephritis.

Acute Disease↗
PubMed1979

[The pathogenesis of chronic pyelonephritis and its therapeutic consequences].

During the last 2 years we examined 186 patients with secondary and 42 patients with primary chronic pyelonephritis. In most cases the secondary pyelonephritis is the sequel of a urolithiasis, less frequently in congenital renal anomalies, adenomas of the prostatic gland and patients with superposed pyelonephritis in renal lesion on account of metabolic disturbances (diabetes, gout) or abuse of analgetics. The course of the disease as well as the results of the therapy show peculiarities in the two forms of pyelonephritis. Thus, for example, the recidivations are more frequently in the secondary pyelonephritis, in the urine culture other germs appear more frequently, and the disease shows a more rapid course. The bacterial sanation in patients with primary pyelonephritis remains stable in the course of one year, where as in the obstructive pyelonephritis (non-operated cases) in the same period all patients show recidivations. After operative treatment of the obstruction the conservative treatment leads to a bacterial sanation in about 70%. In patients with superposed pyelonephritis at first the basic disease is to be treated, i.e. the metabolic disturbances are to be compensated and at the same time an antibacterial therapy is to be performed.

Adult↗
PubMed1979

[Primary pyelonephritis (the focal problem)].

On different experimental models of pyelonephritis in dogs and rabbits an experiment for the classification of the pathogenesis of this disease with the special questioning of the possible development of the so-called primary pyelonephritis was performed. A series of experiments consisted of 3 groups: 1. Injection of an E.-coli-suspension into the musculature of the urinary bladder of dogs and rabbits. 2. Injection of an E.-coli-suspension into the testicles of rabbits. 3. Injection of an E.-coli-suspension into the seminal bladders of rats. The experiments lasted 2 to 15 days and 16 to 110 days, respectively. In the second series of experiment in rats and rabbits an E.-coli-suspension was injected into the gall-bladder of rats and rabbits. Bacteriologic blood cultures and histologic investigations of the kidneys, the ureters, the wall of the urinary bladder and the adjacent lymphatic and fatty tissue as well as of the gall-bladders were performed. The results showed that the pyelonephritis developed secondarily after the infection of the other infected organs by haematogenic or interstitial dissemination of the pathogenic agents. Conclusions are drawn: 1. Every pyelonephritis, also the haematogenic, is a secondary process. 2. Therefore all must be done to find out the primary inflammatory change in the organism and to cure it. 3. Severe forms of the pyelonephritis may, on the other hand, effect as focus and evoke in inflammation of other organs on lymphogenic and haematogenic way. 4. Taking into consideration the facts mentioned perhaps the great number of pyelonephritiides having become latent might be reduced.

Animals↗
PubMed1979

Radiographic findings in induced bacterial pyelonephritis in dogs.

Unilateral bacterial pyelonephritis was induced in nine dogs. The upper urinary tracts of these and six control dogs were evaluated by excretory urography prior to and 9 to 10 days following experimental manipulations. Two of the dogs with unilateral pyelonephritis and one control dog were evaluated at intervals throughout a 58-day period. At necropsy, all nine inoculated kidneys were infected, one experimental dog had bilateral pyelonephritis, and one control dog had unilateral pyelonephritis. Most of the infected kidneys had abnormal radiographic changes 9 to 10 days after induction of infection. There was no statistically significant radiographic change in size of infected kidneys at 9 to 10 days. Seven of the 11 infected kidneys and 7 of the 9 inoculated kidneys had renal pelvic and ureteral dilatation. Of the nine dogs with unilateral pyelonephritis, six had decreased opacity of contrast medium in the collecting system and of the vascular nephrogram on the infected side. The size of infected kidneys decreased progressively during the 58-day period. In one of the two dogs evaluated throughout the period, the collecting system of the infected kidney remained dilated; in the other, it returned toward normal size.

Animals↗
PubMed1978

Interaction of human serum and neutrophils with Escherichia coli strains: differences between strains isolated from urine of patients with pyelonephritis or asymptomatic bacteriuria.

Strains of Escherichia coli isolated from the urine of children with pyelonephritis (n = 18) or asymptomatic bacteriuria (ABU) (n = 20) were serotyped and compared with respect to opsonic requirements, sensitivity to serum, amount of chemiluminescence produced by normal neutrophils during phagocytosis of the various strains, and amount of capsular antigen. Strains isolated from cases of ABU more often had the capacity to activate the alternative complement pathway than had strains causing pyelonephritis. The ABU strains were also better opsonized in fresh human serum and were more often serum sensitive than the pyelonephritic strains. There were individual variations in neutrophil chemiluminescence during phagocytosis of the various strains, but the two groups of strains did not differ significantly. The strains from pyelonephritis cases produced a greater amount of capsular antigens than the ABU strains. There was no correlation between presence of a particular O or K antigen and capacity to activate the alternative complement pathway. The observed differences between strains isolated from patients with ABU and those isolated from patients with pyelonephritis may be relevant for further studies on differences in bacterial virulence or host defense factors.

Antigens, Bacterial↗
PubMed1979

[Significance of the ability of E. coli to alter capillary permeability for the reproduction of pyelonephritis in mice].

Experiments in a number of biological models showed that the cultures of E. coli isolated from the urine of children with pyelonephritis had a varied spectrum of pathogenic properties. Histologically confirmed pyelonephritis induced by intravenous infection in CBA mice, treated with 5% glucose by the method of Montgomerie et al., correlated with the bacterial adhesiveness to the epithelium and the interference with capillary permeability, registered in experiments on the pulmonary model with Evans blue used for control. The criterion for the development of pyelonephritis in mice, which was based, in the opinion of Mintogemerie et al., on the positive results, indicating the presence of the infecting agent in the culture obtained by inoculation with the samples of urine and kidney tissue, was found to be insufficient, as only 28 out of 45 cultures of E. coli isolated from the kidneys coincided with histologically confirmed cases of pyelonephritis.

Animals↗
PubMed1979

[Chronic pyelonephritis in adults (author's transl)].

The frequency of chronic pyelonephritis is often overestimated. Chronic pyelonephritis is probably always a secondary disease in cases with obstructive changes in the ureters or other primary renal damage. The influence of chronic infection on the progression of renal insufficiency is still not well understood today. Underlying disease and infection should always be taken into consideration in the treatment of chronic pyelonephritis.

Adult↗
PubMed1979

Alanine-aminotransferase activities in the renal tissue during experimental and chronic human pyelonephritis.

In chronic experimental and human pyelonephritis (PN) simultaneously renal enzyme and phosphatide analyses and quantitative histological examinations were performed. The results reported in this study refer only to alanine-aminotransferase (AlAT) activities. 139 rabbits developed unilateral experimental pyelonephritis, in further 19 rabbits the experimental PN did not settle or "healed up spontaneously". 31 samples of human pyelonephritis nephrocirrhotic kidneys and 20 samples of healthy human kidneys were examined. Glomerular AlAT-activities increased initially up to the 31-days series, thereafter they decreased without any exception. In the cortical tubules of the rabbit kidneys the enzyme activities increased also up to the 31-days-series, later on they decreased extremely. The medullary AlAT-activities similarly showed increasing values till the 31-days-series, which were followed by sharply depressed data. In the "spontaneously healed up" tissue the glomerular AlAT was increased more than 100%, the cortico-tubular one nearly 100%, and the AlAT of the medulla paralleled the increased values of the 20-days series nearly. The human samples of pyelonephritic nephrocirrhosis showed in all 3 fractions (glomerula, cortical tubules and medulla) extremely depressed AlAT-activities. The significance calculations (universally applied t-test) showed an overhelming majority of the values with significance (p less than 0.001). The measured enzyme activities correlate well with the quantitative histological examinations.

Alanine Transaminase↗
PubMed1977

Significance of antibody-coated bacteria in urinary sediment in experimental pyelonephritis.

The sequential appearance of antibody-coated bacteria in urinary sediment was followed in experimental pyelonephritis produced with Escherichia coli O6:K13:H1. It was possible to determine against which antigen of the organism this antibody was directed. Antibody-coated bacteria appeared by day 11 of infection, a time which coincided with the synthesis of local (intrarenal) antibody. Bacteria coated with antibody more than three days after serum antibody but four days before urinary antibody appeared. Antibody eluted from coated bacteria was directed against the O-antigen of the infecting organism but not the K-antigen. Newly synthesized intrarenal antibody and urinary antibody were directed only against O-antigen, but not against K-antigen; this finding would explain why the antibody that coated the bacteria was antibody to lipopolysaccharide. Thus, a positive test for antibody-coated bacteria indicates that a local immune response to O-antigen has occurred. It is postulated that this immune response could relate to the clinical symptomatology of acute symptomatic pyelonephritis since most patients presenting with acute pyelonephritis have bacteria coated with antibody.

Animals↗
PubMed1979

Synergism of ampicillin and gentamicin against obstructive pyelonephritis due to Escherichia coli in rats.

Rats with obstructive pyelonephritis due to Escherichia coli were treated for different intervals with ampicillin and gentamicin either alone or in combination. The combination of ampicillin and gentamicin was synergistic in vitro and significantly more effective in vivo than was either drug alone. After treatment for 10 days, the combination of ampicillin and gentamicin was the only regimen that sterilized all of the pyelonephritic kidneys. The importance of achieving sterility was illustrated by the observation that severe infection and acute pyelonephritis recurred after religation of the ureter in 12 (71%) of 17 ampicillin-treated animals that had harbored as few as 46 organisms per kidney before ligation. A synergistic combination of antibiotics rapidly sterilizes obstructed pyelonephritic kidneys. In view of the particular risk of renal infection in the presence of urinary obstruction in humans, synergistic antibiotic combinations may be useful in the treatment of obstructive pyelonephritis in humans.

Acute Disease↗
PubMed1979

Suppressed lymphocyte mitogen-responsiveness in urinary tract infections of children and its correlation to pyelonephritis.

Cell-mediated immunity (CMI) was studied in a group of 48 children with urinary tract infections (UTI) using a whole blood micromethod for lymphocyte stimulation in vitro. The patients were subdivided into pyelonephritis group (27 cases) and lower urinary tract infection (LUTI) group (21 cases) on the basis of fever, erythrocyte sedimentation rate, C-reative protein and renal concentration capacity. At the acute stage of infection the lymphocyte responsiveness to leucoagglutinin (LA) and concanavalin A (Con A) was suppressed in both groups, but the suppression was much greater in those with pyelonephritis. By 6 weeks after infection the lymphocyte responses were normal in most but not all cases. We conclude that an acute pyelonephritis is associated with marked suppression of CMI and that the latter can be used as an additional criterion for establishing the level of infection. Patients with UTI did not generally appear to have any primary defect of CMI but when suppression of CMI was present, it seemed secondary to an ongoing infection.

Agglutinins↗
PubMed1977

Influence of acetohydroxamic acid on experimental Corynebacterium renale pyelonephritis.

The role of Corynebacterium renale urease in the establishment of pyelonephritis was studied by the oral administration of acetohydroxamic acid (AHA), a urease inhibitor, to experimentally infected rats. The bacteria were introduced by surgical insertion of a zinc disc containing 1 X 10(6) colony-forming units of C-renale into the urinary bladder whereas sterile discs were implanted in the bladders of the control animals. Daily administration of AHA via the drinking water did not halt the development of pyelonephritis. Larger doses, given by gavage, did accomplish this goal; that is, the pH of the urine was lowered, the number of colony-forming units of C. renale in the kidney was reduced drastically, and pyelonephritic lesions were observed in the kidney by light-microscopic examination. All experimental rats developed cystitis in varying degrees of severity. About 70% of the intact AHA given by gavage was excreted in the urine 24 h after administration of this compound. Rats implanted with a urease-negative mutant of C. renale displayed no signs of pyelonephritis but did develop cystitis.

Animals↗
PubMed1979

The sonographic appearance of acute pyelonephritis.

Acute pyelonephritis and acute ureteral obstruction often present with similar clinical and urographic findings. Ultrasound, however, can easily detect the presence of obstruction as well as demonstrate characteristic findings suggestive of acute pyelonephritis, and thus allows differentiation. In two patients with acute pyelonephritis, the ultrasonic findings consisted of a large swollen kidney with an increased anechoic corticomedullary area, with multiple scattered low-level echoes. Each of the two cases is discussed in detail.

Acute Kidney Injury↗
PubMed1979

Immunological aspects of pyelonephritis.

Several virulence factors, such as O and K antigens and capacity to attach to uroepithelial cells, seem to be required for Escheria coli to cause acute pyelonephritis. These factors induce an immune response, however, which can modify the course and clinical expression of the infection. During acute pyelonephritis, autoantibodies to the Tamm-Horsfall protein increase. These antibodies, which probably are evoked by a cross-reaction noted between structures of E. coli LPS and the Tamm-Horsfall protein, may add to the renal tissue engagement in interstitial nephritis caused by bacterial pyelonephritis.

Acute Disease↗
PubMed1978

[Urgent problems in the study of pyelonephritis in children].

The literature data and own observations concerning the features of patho- and morphogenesis of pyelonephritis in children are presented. Particular attention is given to the importance of renal tissue and intrarenal blood vessels dysplasia in the genesis and development of pyelonephritis as well as to the pathogenetic role of inflammatory processes in urinary tract wall in obstructive uropathies. The importance of morphological studies in diagnosis, prophylaxis and treatment of pyelonephritis in children is emphasized.

Age Factors↗
PubMed1978

[Diagnostic value of determining urinary fibrin split products in glomerulonephritis, pyelonephritis and graft rejection].

On 112 patients with bioptically ascertained chronic proliferative glomerulonephritis, 94 with pyelonephritis and 23 patients with kidney transplantation altogether 1,050 times the fibrin fission products in the urine were estimated by the passive haemagglutination after Merskey. It was the aim of the investigation to test the diagnostic evidence described in literature concerning the floridity diagnostics in glomerulonephritis and the recognition of rejection in kidney transplantation as to its reproducibility. In comparison to the latent glomerulonephritis (0.3 microgram/ml) the florid glomerulonephritis (12.3 microgram/ml) as well as the acute pyelonephritis (9.2 microgram/ml) in comparison to the chronic pyelonephritis (1.3 microgram/ml) has significantly higher values. On account of the numerous "falsely positive" and "falsely negative" values in contrast to the data of other authors an activity diagnostics is not possible. Only in the glomerulonephritis with nephrotic syndrome a prognostic use is to be expected: Patients with steroid-sensitive nephrotic syndrome do not secrete any fibrin fission products in the urine and patients with steroid-resistant nephrotic syndrome secrete them in a large number. We could confirm that an increase of the fibrin fission products in the urine after kidney transplantation refers to an acute rejection crisis. Since 10 of 27 rejections were fibrin fission product-negative, in the lacking fibrin fission products in the urine a rejection is not be excluded, by which the diagnostic value is restricted.

Fibrin Fibrinogen Degradation Products↗