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Biomedical subjects

K Lincoln

Publications and source records attributed to K Lincoln.

At least 37 records · Page 2Linked to original sources
PubMed1988

Bacterial attachment and inflammation in the urinary tract.

The mechanism whereby attachment enhances Escherichia coli virulence in the urinary tract was studied by a detailed analysis of the host response to bacteriuria. Episodes of bacteriuria in 1473 children were followed prospectively from 1970 to 1984. To study the inflammatory response to the bacteriuric epidoses, we recorded body temperature, C-reactive protein, microsedimentation rate, urinary leukocyte count, and renal concentrating capacity. Bacterial isolates from each episode were identified and saved, and the adhesive capacity of 2669 E. coli strains was defined by their binding to galactose alpha 1----4galactose beta-containing receptors. Inflammatory response was significantly higher and renal concentrating capacity significantly lower during episodes caused by attaching strains. There was a linear relation between the number of indicators of inflammation and the proportion of galactose alpha 1----4galactose beta-binding strains present. Vesicoureteric reflux potentiated the inflammatory response. Attaching strains of E. coli thus appeared to be more capable of causing inflammation than were other bacteria. The potentiating effect of attachment on inflammation explains the over-representation of galactose alpha 1----4galactose beta-recognizing bacteria in patients with acute pyelonephritis.

Bacterial Adhesion↗
PubMed1988

Virulence of Escherichia coli in relation to host factors in women with symptomatic urinary tract infection.

The relationship between bacterial characteristics and the severity of urinary tract infection in adults has not been clarified. In this study, Escherichia coli strains (n = 178) were prospectively collected from women with community-acquired urinary tract infection. The isolates were identified by O:K:H serotype and characterized for adherence, hemolysin production, and serum bactericidal resistance. The patients had acute pyelonephritis with or without complicating factors and acute cystitis. Nine serotypes (O1:K1:H7, O1:K1:H-, O2:K1:H-, O4:K12:H1, O7:K1:H-, O9:K34:H-, O16:K1:H6, O16:K1:H-, and O75:K5:H-) comprised 65% of the strains in uncomplicated pyelonephritis, but were significantly less often encountered in complicated pyelonephritis or cystitis. Adherence was the single property most characteristic of the pyelonephritogenic clones. Adhesins specifically recognizing Gal alpha 1----4Gal beta-containing receptors occurred in 80% of strains in uncomplicated pyelonephritis, in 50% of strains in complicated infections, and in 37% of cystitis strains. Hemolysin production and serum resistance did not correlate with any disease pattern. Advanced age did not seem to reduce the selection of virulent E. coli to cause pyelonephritis. These results demonstrate in women a relationship between E. coli virulence and the severity of urinary tract infection analogous to that previously observed in pediatric populations and also illustrate the balance between host resistance and bacterial virulence in the urinary tract.

Acute Disease↗
PubMed1988

Variable in vitro activity of cefaclor, cephalothin and cefadroxil against Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis.

The in vitro activity of cefaclor, cephalothin and cefadroxil to 50 Escherichia coli, 23 Klebsiella pneumoniae and 20 Proteus mirabilis strains was tested with the disc diffusion and microdilution plate techniques. Cefaclor was more active than cefadroxil, while cephalothin was intermediate. The differences seriously affected the classification into the routine SIR system. For susceptibility testing we question the use of cephalothin as a class representative of oral cephalosporins.

Cefaclor↗
PubMed1986

Treatment of bacterial vaginosis with an acid cream: a comparison between the effect of lactate-gel and metronidazole.

Bacteriological isolation of anaerobes, Gardnerella and lactobacilli was carried out in a group of 62 women with the diagnosis bacterial vaginosis and 42 control women. Lactobacilli were the predominant organisms in the control group whereas anaerobes dominated the flora in bacterial vaginosis patients. Lactate-gel (pH 3.5, 5 ml) inserted into the vagina daily for 7 days is as effective as oral metronidazole, 500 mg twice daily for 7 days. The women in both groups became symptom-free and objectively improved. Anaerobes were significantly reduced (p less than 0.0001) in both groups after 1-week treatment but Gardnerella was not significantly reduced. As bacterial vaginosis is generally looked upon as a mild noninflammatory condition lactate-gel seems to be an ideal treatment for this disease.

Adult↗
PubMed1984

Virulence-associated traits in Escherichia coli causing first and recurrent episodes of urinary tract infection in children with or without vesicoureteral reflux.

Virulence-associated properties of 606 urinary isolates from 174 children with urinary tract infections were related to severity of infection and factors increasing host susceptibility, e.g., vesicoureteral reflux (grade II or higher) and P1 blood group phenotype. A high proportion of strains of Escherichia coli causing first or recurrent episodes of acute pyelonephritis in children without reflux expressed the previously noted high frequency of certain O antigens, resistance to serum killing, hemolysin production, and adhesive capacity. A significantly lower frequency of these traits and a higher frequency of non-E. coli were seen among isolates from children with pyelonephritis and reflux, cystitis, and asymptomatic bacteriuria. Reflux was thus found to be a determinant of the level of infection and of the bacterial properties required to produce pyelonephritis. Efforts aimed at preventing or treating urinary tract infection by interfering with "virulent" bacteria may be of less value in patients with recurrent pyelonephritis and reflux, who are most likely to develop renal scars.

Adhesiveness↗
PubMed1983

Three-day treatment of acute lower urinary tract infections in women. A double-blind study with amoxycillin and co-trimazine.

The aim of this study was to determine if a three-day treatment of lower urinary tract infection (UTI) is effective. 215 women with symptoms of lower UTI, seen in general practice, were randomly allocated to a double-blind study and given either amoxycillin 1000 mg twice a day for three days or trimethoprim 90 mg/sulphadiazine 410 mg (co-trimazine) 2 tablets initially, then one tablet twice daily for three days. 157 women (73%) had significant bacteriuria. Therapeutic efficacy was evaluated in 146 patients. One week after treatment had started, 88% of the women in the amoxycillin group and 100% in the co-trimazine group were cured (p less than 0.01). After a follow-up period of four weeks, the cumulative relapse frequencies were 19% and 9% respectively. Adverse reactions were mild in most cases. Two patients, both on co-trimazine, had to discontinue treatment because of nausea and vomiting. Vulvovaginal irritation was more often reported by women treated with amoxycillin (n = 8) than by those treated with co-trimazine (n = 1) (p less than 0.05). It is concluded that a three-day course of amoxycillin or co-trimazine in lower UTI is safe, causes few adverse reactions, is simple to administer and comfortable for the patient. Co-trimazine seems to be more effective than amoxycillin.

Adolescent↗
PubMed1982

Long-term treatment with pivmecillinam in patients with recurrent bacteriuria.

Thirty out-patients with chronic recurrent urinary tract infections, who had failed to respond to 10 days treatment with either pivmecillinam and/or amoxycillin, received a 3-month course of pivmecillinam at a dose of 200 mg, three times daily. Twenty-seven patients had bacteriuria due to Enterobacteriaceae, mainly Escherichia coli, sensitive to mecillinam in vitro. Pivmecillinam eradicated all the initial urinary pathogens. Reinfections occurred during treatment in three patients, who remained asymptomatic. Four subjects complained of gastro-intestinal side-effects, and therapy was withdrawn in three instances. Another three patients described unusual adverse events towards the end of the course of treatment, described as an odd sensation in the body and a desire for salt. The sensation disappeared a few days after the end of treatment. Treatment with pivmecillinam had no adverse effect on haematopoietic, hepatic or renal function.

Adolescent↗
PubMed1982

Low dose trimethoprim prophylaxis in long term control of chronic recurrent urinary tract infection.

26 patients with chronic urinary tract infections (UTI) were treated with 1 tablet of 100 mg trimethoprim (TMP) once daily for up to 6 months as long term prophylaxis. The recurrence rate before prophylaxis was 26/100 months, compared to a significantly lower frequency (3.3 recurrences/100 months, p less than 0.001) during prophylaxis. The post-prophylactic rate returned to the pre-prophylaxis rate: 23 recurrences/100 months. All Escherichia coli strains causing post-prophylactic UTI were TMP sensitive. The number of rectal enterobacteria were markedly reduced during prophylaxis (p less than 0.05). A 10% recovery of TMP resistant enterobacteria from rectal swabs was noted early (less than or equal to 1 month) during prophylaxis, but no significant further accumulation occurred.

Adolescent↗
PubMed1980

Bacteriuria in a population sample of women. Prevalence, characteristics, results of treatment, and prognosis.

The prevalence of bacteriuria was studied in a population sample of women aged 38-60. Significant (greater than or equal to 100 000 bacteria/ml of the same species in two consecutive specimens) or "probable" bacteriuria (greater than or equal to 100 000 in the first and 20 000-90 000 bacteria/ml of the same organism in the second specimen) were found in 5% of the women, increasing from 3.5% in women aged 38 to 8.6% in women aged 60. Escherichia coli predominated (90% of those with significant bacteriuria), and 91% of the Escherichia coli strains were sensitive to sulphonamides. About half of the women who were non-bacteriuric after short-term treatment had one or more recurrent urinary tract infections during a two-year follow-up period. Serum creatinine and urine concentrating capacity did not differentiate women with significant or "probable" bacteriuria from the others. Pathological radiological changes were found in 17% of bacteriuric women who were submitted to i.v. pyelography. When re-examined six years after the first study, 23% of initially bacteriuric and 5% of initially non-bacteriuric women had bacteriuria. Patients with renal lesions have been followed for ten years, but none of them has developed progressive renal impairment. Three women with chronic pyelonephritis and acute pyelonephritic attacks in the past were discovered when screening the concentrating capacity in this population sample, but they were non-bacteriuric when screening for bacteriuria. A study of this kind must be conducted over many years before valid conclusions can be drawn.

Adult↗
PubMed1979

Chronic papillomatous dermatitis as a peristomal complication in conduit urinary diversion.

In 76 patients with conduit urinary diversion, the skin in the stomal area was studied with regard to complications. No such complications had occurred in 39 cases. Superficial erosive dermatitis was present or had been a transient episode in 27 cases. The immediate peristomal area was found in ten cases to show a different type of complication. This was characterized by hyperplastic, papillomatous skin lesions of a chronic nature. A rubber urinary collecting device for long-term use had been fitted in nine of the ten patients, and none of them had a protruding nipple stoma. The clinical, microbiologic and histologic features of these hyperplastic lesions are described and aetiologic factors are discussed. Change to another type of collecting device was followed within three to six weeks by healing of the lesions.

Adolescent↗
PubMed1978

The homogeneity of the faecal coliform flora of normal school-girls, characterized by serological and biochemical properties.

The homogeneity of fecal coliform flora in 52 schoolgirls was studied by serotyping and biotyping 10 randomly selected colonies in one fecal culture from each child. Ninety-eight clones were identified and of these 52 were dominant and 46 were minor strains. The probability of including at least one isolate of the dominant clone in a small random sample of colonies was calculated to be 86% for one colony, 94% for 2, 97% for 3, 99% for 4, and 99.3% for 5 randomly selected colonies.

Adolescent↗
PubMed1977

Comparison of Escherichia coli from bacteriuric patients with those from feces of healthy schoolchildren.

The properties of 709 strains of Escherichia coli isolated from feces of healthy schoolchildren were compared with those of 115 strains from the urine of girls with asymptomatic bacteriuria (ABU) detected in a screening program. These fecal strains were also compared with 45 strains that caused asymptomatic reinfections and 10 that caused symptomatic reinfections in the same group of girls. Typing of O antigen was done by direct bacterial agglutination, and K typing was done with a serum agar technique. Hemolytic capacity was assessed in solid medium. Sensitivity to the bactericidal effect of normal serum and minimal inhibitory concentrations of ampicillin were also determined. The strains isolated from girls who had reinfections of ABU were found to be a random sample of the fecal flora, but the strains from children with symptomatic reinfection were not. Strains from index patients with ABU differed from the other groups in a way that was indicative of adaptive changes in the structure of cell envelopes.

Adolescent↗
PubMed1977

Characteristics of antibiotic-resistant Escherichia coli in the rectum of healthy school-children.

During a 3-year period, 771 rectal swabs were taken from abacteriuric school-children. Out of 709 E. coli strains, each isolated from one faecal specimen, 102 were found to be resistant to one or more antibacterial agents, and 607 to be fully sensitive. Another 204 resistant strains were found by selection for antibiotic resistance. The antibiotic-sensitive and the resistant strains were found to be two somewhat different populations, distinguished by a different distribution of O antigen types. Also, the K1 antigen was more common among the sensitive than among the resistant strains. Resistant strains that were not O typable were very seldom haemolytic.

Adolescent↗