Disease relevance of Pyelonephritis

• K1 isolates account for 80% of E. coli neonatal meningitis and comprise the majority of capsular types in neonatal septicaemia without meningitis and in childhood pyelonephritis [1].
• We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy [2].
• Acute renal failure occurred during indomethacin therapy in a patient with chronic pyelonephritis [3].
• Development of experimental model of chronic pyelonephritis with Escherichia coli O75:K5:H-bearing Dr fimbriae: mutation in the dra region prevented tubulointerstitial nephritis [4].
• E. coli pyelonephritis produced a similar adrenal response, although the peak serum corticosterone caused by pyelonephritis was less than the serum corticosterone occurring during the first peak of eosinophilia during trichinosis [5].

High impact information on Pyelonephritis

• Among 36 girls with recurrent pyelonephritis who did not have vesicoureteral reflux, we found that attaching bacteria were common and the P1 blood-group phenotype was present in 97 per cent, as compared with 75 per cent of 84 age-matched children without urinary-tract infection (P less than 0.01) [6].
• To assess the role of complement in renal infection, we studied a model of Escherichia coli-induced pyelonephritis in mice deficient in complement components C3 and C4 [7].
• CONCLUSIONS: In our study of outpatient treatment of acute uncomplicated pyelonephritis in women, a 7-day ciprofloxacin regimen was associated with greater bacteriologic and clinical cure rates than a 14-day trimethoprim-sulfamethoxazole regimen, especially in patients infected with trimethoprim-sulfamethoxazole-resistant strains [8].
• Comparison of ciprofloxacin (7 days) and trimethoprim-sulfamethoxazole (14 days) for acute uncomplicated pyelonephritis pyelonephritis in women: a randomized trial [8].
• Renal papillary necrosis and pyelonephritis accompanying fenoprofen therapy [9].

Chemical compound and disease context of Pyelonephritis

• OBJECTIVE: To compare the efficacy and safety of a 7-day ciprofloxacin regimen and a 14-day trimethoprim-sulfamethoxazole regimen for the treatment of acute pyelonephritis in women [8].
• A study of the intrarenal recycling of urea in the rat with chronic experimental pyelonephritis [10].
• The initial pathogenic step in nonobstructive Escherichia coli pyelonephritis usually involves the binding of a bacterial adhesin with host uroepithelial glycoprotein receptors containing the D-Gal p alpha 1----4 D-Gal p beta 1 (Gal-Gal) moiety [11].
• Typing antisera for sixteen capsular acidic polysaccharide K antigens were used, and five (numbers 1, 2, 3, 12, and 13) accounted for 70% of isolates from patients with acute pyelonephritis [12].
• Mannose-resistant haemagglutination and P antigen recognition are characteristic of Escherichia coli causing primary pyelonephritis [13].

Biological context of Pyelonephritis

• An insertional dra mutant, E. coli DR14, of the clinical E. coli isolate IH11128 bearing Dr fimbriae, was constructed and used to characterize persistence of infection and interstitial tropism in an experimental model of ascending pyelonephritis [4].
• Antiserum to synthetic peptide R5-12, which corresponds to a region of conserved sequence, bound Gal-Gal pilins from seven of eight pyelonephritis strains, indicating that it specifies a crossreacting protective epitope [14].
• The heterogeneity in the binding sites of E. coli DAF (Dr) family adhesins from gestational pyelonephritis isolates may reflect the ability of the adhesins to evolve to recognize alternate peptide epitopes for efficient colonization [15].
• RESULTS: On univariate and multivariate analysis the papG class II allele was the only virulence gene associated with acute pyelonephritis (p <0.0001 and 0.001, respectively) [16].
• During 39 pregnancies, 33 women with a history of recurrent UTIs (and, in some instances, pyelonephritis) received postcoital prophylaxis consisting of a single oral dose of either cephalexin (250 mg) or nitrofurantoin macrocrystals (50 mg) [17].

Anatomical context of Pyelonephritis

• Tubular epithelial cells are among the non-immune cells that express TLR1, -2, -3, -4, and -6, suggesting that these TLR might contribute to the activation of immune responses in tubulointerstitial injury (e.g., bacterial pyelonephritis, sepsis, and transplant nephropathy) [18].
• Toll-like receptor-4: renal cells and bone marrow cells signal for neutrophil recruitment during pyelonephritis [19].
• Moreover, in the patients with pyelonephritis, MMP-9/TIMP-1 ratios in urine correlated with the degree of leukocyte transmigration [20].
• During a period of i.a. infusion of heparinized saline ranging from 19 to 63 days, serum creatinine remained normal in all but 1 animal, which developed pyelonephritis and catheter-tip perforation of the iliac artery [21].
• A gentamicin survival assay, using primary human renal epithelial cells and Escherichia coli strains isolated from the feces of asymptomatic individuals and from the urine or blood of patients with acute pyelonephritis, was used to investigate bacterial internalization as a model for renal parenchymal invasion in pyelonephritis [22].

Gene context of Pyelonephritis

• Urinary levels of tissue inhibitor of metalloproteinase 1 (TIMP-1) higher than those of matrix metalloproteinase 9 (MMP-9) during acute pyelonephritis have previously been associated with a higher degree of acute inflammation and of postinfective renal scarring [20].
• In contrast, TLR4 is not expressed on human proximal tubule cells isolated from the renal cortex, which may explain the cortical localization of bacteria in pyelonephritis [23].
• PURPOSE: We compared serum amyloid A (SAA) protein, C-reactive protein (CRP), interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha as inflammatory markers for pyelonephritis and cystitis [24].
• The aim of this study was to investigate the influence of IL-6 on mortality, bacterial growth and cytokine expression in experimental acute pyelonephritis [25].
• We therefore conclude that IL-6 plays an important role in bacterial clearance and directly influences the TGF-beta levels in experimental acute pyelonephritis [25].

Analytical, diagnostic and therapeutic context of Pyelonephritis

• The obstructed kidney showed mild pyelonephritis, but both kidneys showed a glomerulopathy with electron-dense deposits in the mesangial and paramesangial regions associated with positive immunofluorescence for immunoglobulin M (IgM) and the third component of complement (C3) [26].
• Diuretic MAG3 scintigraphy (F0) in acute pyelonephritis: regional parenchymal dysfunction and comparison with DMSA [27].
• CONCLUSION: Although the sensitivity of SPECT for the detection of acute pyelonephritis is slightly better than pinhole DMSA scan, the overall accuracy of these two imaging techniques is essentially the same [28].
• In vivo, dapsone treatment had no significant effect on acute pyelonephritis with respect to (i) bacterial counts, (ii) inflammatory swelling, and (iii) PMN infiltration [29].
• Ciprofloxacin has proved its value in good clinical trials for uncomplicated acute pyelonephritis and has been used widely for complicated urinary tract infections with presumed renal infection [30].

References