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Biomedical subjects

K F Fairley

Publications and source records attributed to K F Fairley.

At least 55 records · Page 3Linked to original sources
PubMed1984

Culture of mid catheter urine collected via an open-ended catheter: a reliable guide to bladder bacteriuria.

Colony counts were compared from urine samples obtained by suprapubic aspiration and via a short, wide bore, open-ended urethral catheter. We studied 30 female patients in whom suprapubic aspiration of bladder urine was necessary to confirm the presence of bacteriuria with conventional or fastidious organisms. Catheterization was done immediately following suprapubic aspiration. Culture results of mid catheter urine specimens were similar to those from suprapubic aspiration urine specimens in 27 of 30 patients, a result considerably superior to that obtained with a conventional side-hole catheter. We conclude that a short, wide bore, open-ended catheter should be used to obtain urine specimens from female patients. Results confirm catheter specimens to be a satisfactory alternative to bladder aspiration of urine for detection of bacteriuria caused by fastidious micro-organisms or in patients with low numbers of conventional urinary tract pathogens.

Bacteriuria↗
PubMed1984

The clinical course of mesangial IgA associated nephropathy in adults.

Clinical data in 244 patients with IgA nephropathy and biopsy findings in 519 biopsies (107 patients had at least two biopsies) were analysed. Males predominated (73 per cent) and had more severe disease and a worse prognosis than females. The most frequent symptom was macroscopic haematuria, often with associated loin pain; however, this was typical only in young males. Hypertension was the major presenting feature in 23 per cent of patients. Urinary erythrocyte counts correlated with the presence of crescents on biopsy (p less than 0.0001). Serum IgA levels wer elevated in only 21 per cent, while IgM levels were raised in 43 per cent of patients. Two hundred and seventeen patients were followed for at least one year (mean 59.7 months, range 12-255 months). In 82 patients five-year follow-up and in 33 patients ten-year follow-up data were available. Five- and 10-year survival figures were 91.5 and 87.5 per cent respectively. Clinical resolution occurred in only 6 per cent of patients but in those who had biopsies following clinical resolution, diffuse mesangial cell proliferation and IgA deposits persisted in all. The rate of clinical deterioration correlated with proteinuria, hypertension, impaired renal function, crescents and sclerosed glomeruli on biopsy. Continuing high urinary erythrocyte counts were the strongest predictor of a progressive course.

Adolescent↗
PubMed1983

Comparison of mid catheter collection and suprapubic aspiration of urine for diagnosing bacteriuria due to fastidious micro-organisms.

We examined 40 female patients for the presence of fastidious bacteria in the bladder by culture of mid catheter and suprapubic aspiration urine specimens. Gardnerella vaginalis and Ureaplasma urealyticum were the most frequently isolated fastidious species. The suprapubic aspirate was positive in 3 patients with more than 10(5) colony-forming units per ml. Gardnerella vaginalis and 7 with more than 10(2) colony-forming units per ml. Ureaplasma urealyticum in the mid catheter urine specimen, while it was negative for bacteria in 6 patients with less than 10(4) colony-forming units per ml. coryneform bacilli or lactobacilli in the mid catheter urine specimen. The results show that culture of mid catheter urine samples provides a reasonable guide to the presence of bacteriuria owing to fastidious micro-organisms and can be used when a suprapubic aspiration specimen cannot be obtained easily.

Bacteriological Techniques↗
PubMed1983

Unconventional bacteria in urinary tract disease: Gardnerella vaginalis.

Bladder aspirate urine samples (N = 190) were cultured for the presence of fastidious microorganisms. These samples were obtained from patients with urinary tract disease in whom standard bacteriologic investigation had failed to indicate infection. Gardnerella vaginalis was recovered alone, or in association with Ureaplasma urealyticum from the bladder urine of 33% of patients with reflux scarring. G. vaginalis was localized to the upper urinary tract in 75% of these patients with bladder counts greater than 10(3) colony-forming units per milliliter. The results show that two fastidious microbial species, not conventionally associated with urinary tract infection, are recoverable from the upper urinary tracts of patients with so-called sterile pyelonephritis.

Bacterial Infections↗
PubMed1983

Bacteriuria due to Ureaplasma urealyticum and Gardnerella vaginalis in women with preeclampsia.

Certain fastidious organisms such as U urealyticum and G vaginalis can be isolated from the aspirated bladder urine of pregnant women more frequently than conventional urinary pathogens such as Escherichia coli [1]. They can be isolated even more often from the aspirated bladder urine of patients with renal disease, but rarely from that of healthy men or nonpregnant women [2]. We investigated the incidence of bacteriuria due to these two organisms--particularly U urealyticum--in patients with preeclampsia. U urealyticum was isolated more frequently (rate, 20%), and usually in higher colony counts, from the urine of patients with preeclampsia than from that of healthy pregnant women (rate, 7%). G vaginalis was isolated with approximately the same frequency as U urealyticum from specimens of bladder urine; both organisms were isolated from the urine of 11 patients (eight healthy women and three with preeclampsia). High colony counts of G vaginalis were also found more frequently in patients with preeclampsia. In both groups other fastidious organisms were isolated in a total of only five patients, and in four of these five cases U urealyticum and/or G vaginalis were also isolated from the same specimen. Urine cultures were more frequently positive in patients with moderately severe hypertension (blood pressure, greater than 160/100 mm Hg) than in those with mild hypertension (blood pressure, 140/90-160/100 mm Hg, occurring in nine (53%) of 17 patients and in nine (26.5%) of 34 patients, respectively. This difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteriuria↗
PubMed1983

Polycythemia vera and glomerulonephritis.

Six patients with polycythemia vera and proteinuria are described. Three patients had histologically defined glomerulonephritis. It is proposed that there is an association between polycythemia vera and the development of glomerulonephritis. Possible pathogenetic mechanisms are discussed.

Adult↗
PubMed1983

Urinary erythrocyte morphology in the diagnosis of glomerular hematuria.

Urine samples from 141 consecutive patients referred for investigation of microscopic hematuria were examined by phase-contrast microscopy to determine the probable site of bleeding into the urinary tract. Dysmorphic (i.e. morphologically variable) erythrocytes, suggestive of glomerular bleeding, were present in 86 of 87 patients with significant hematuria who were later shown to have glomerulonephritis. In contrast, all of 30 patients with non-glomerular lesions had isomorphic (i.e. morphologically uniform) erythrocytes in the urine. Ten patients yielded a mixed morphologic pattern suggestive of dual pathology which was confirmed in four patients. Urine erythrocyte counts from 376 healthy individuals showed that 95% yielded less than 8,000 cells/ml and in each case erythrocytes exhibited a dysmorphic pattern suggesting that erythrocytes enter the urine of healthy subjects via the glomerulus. Electron microscopy of urinary erythrocytes from 36 patients with glomerulonephritis demonstrated the range of dysmorphic changes characteristic of glomerular bleeding, presumably resulting from environmental changes suffered by the erythrocytes within renal tubules.

Adolescent↗
PubMed1982

Urinary red-cell morphology during exercise.

Midstream urine samples were examined by phase-contrast microscopy before and immediately after 48 subjects participated in a long-distance run. Minor abnormalities were found in six samples before exercise. Eighteen subjects developed proteinuria and five haematuria on dipstick testing after exercise. Forty-four subjects had increased urinary red-cell counts after exercise; of these, 33 had counts above the normal range (800/ml). In all subjects urinary red cells were dysmorphic both before and after exercise, indicating a glomerular source. Ten subjects developed red-cell casts and 42 showed an increase in hyaline and hyaline-granular casts after exercise. There were modest increases in urinary white-cell counts in 35 subjects but little change in urine pH or osmolality with exercise. This study confirms that urinary red-cell counts commonly increase appreciably after exercise. The dysmorphic appearance of the red cells together with the presence of red-cell casts indicates a glomerular source for this common form of exercise haematuria.

Adolescent↗
PubMed1982

Haematuria associated with ureaplasma infection in sickle-cell trait.

Phase-contrast microscopy of the urine of a young Greek woman with macroscopic haematuria showed sickling of the red blood cells. The diagnosis of sickle-cell trait was confirmed with haemoglobin electrophoresis, and an intravenous pyelogram demonstrated the typical medullary cavities seen in this disease. Urine collected from the left ureter, from which the haematuria originated, grew 10(6) Ureaplasma urealyticum/ml. With Doxycycline therapy the macroscopic haematuria and the sickled cells in the urine resolved, but red cell casts and an excessive number of glomerular red blood cells persisted in the urine, confirming the presence of glomerulonephritis. Ureaplasma urealyticum has not previously been described in association with a sickling episode nor with the scarring of a sickle cell kidney. The possible role of this infection is discussed.

Adult↗
PubMed1981

Unconventional bacteria in urinary tract disease: Ureaplasma urealyticum.

Bladder-aspirate urine samples (N = 428) were cultured for the presence of fastidious microorganisms. These samples were obtained from 190 patients with urinary tract disease or symptoms suggesting infection of the urinary tract in whom standard bacteriologic investigation had failed to indicate bacterial infection. Ureaplasma urealyticum was recovered alone or in association with other microorganisms from the bladder urine of 75% of patients with reflux scarring and abnormal renal function. Ureaplasma organisms were localized to the upper urinary tract in 80% of patients with bladder counts greater than 10(3) colony-forming units per ml. The results indicate that microorganisms not conventionally associated with urinary tract infection are recoverable from the bladder urine of a high percentage of patients with so-called "sterile pyelonephritis," in which group of patients these microorganisms may contribute to progressive renal disease.

Female↗
PubMed1981

Anaerobic and other fastidious microorganisms in asymptomatic bacteriuria in pregnant women.

Urine from 44 pregnant women with known or suspected renal disease (group 1) and from 50 healthy pregnant women (group 2) with negative routine cultures of midstream urine was obtained by suprapubic aspiration. Aerobic and anaerobic cultures showed bacteriuria in 70% of the women in group 1 and in 26% of those in group 2. Gardnerella vaginalis was the most frequently isolated organism. Ureaplasma urealyticum was isolated from 14(48%) of 29 women in group 1 and from two (12.5%) of 16 women in group 2. Radiologic studies showed a high incidence of underlying renal disease in asymptomatic women with bacteriuria. Localization testing indicated kidney infection in six of 14 women in group 1 and in one of four women in group 2. These findings suggest that there is an increased susceptibility to colonization of the bladder with these microorganisms during pregnancy and that persistence of infection and renal involvement are associated with underlying renal disease.

Anaerobiosis↗
PubMed1981

Ureaplasma urealyticum in the upper urinary tracts of renal allograft recipients.

Urine samples from 123 renal transplant recipients were cultured for the presence of Ureaplasma urealyticum and other fastidious microorganisms. Ureaplasmas were recovered alone or in association with other microbial species from the bladder urine of 13 (11%) of the 123 patients, and evidence of involvement of the upper urinary tract was present in nine patients. Colonization of the upper urinary tract by U. urealyticum was not associated with a decline in function of the grafted kidney and was found only in patients with a primary diagnosis of reflux nephropathy (50% of such patients were positive for ureaplasmas) or glomerulonephritis (10% were positive) who had their own kidneys. The next most common isolate was Gardnerella vaginalis, recovered from 7% of patients, the majority of whom harbored the organism in the bladder only. The results confirm that U. urealyticum may colonize the upper urinary tracts of patients with proven renal disease.

Female↗