Search PubMed⌕ Search

Biomedical subjects

R Fünfstück

Publications and source records attributed to R Fünfstück.

At least 19 recordsLinked to original sources
PubMed2006

DNA fragmentation in chronic glomerulonephritis: an immunohistological analysis.

BACKGROUND: Experimental data suggest that apoptosis plays an important pathophysiological role in glomerulonephritis by restoring tissue structure after proliferation of intrinsic renal cells and infiltration of leukocytes. Relatively little is known of apoptosis in human glomerulonephritis, particularly in predicting renal function during follow-up. METHODS: In order to colocalize different markers for cell damage in renal tissue from patients with different forms of glomerulonephritis (GN), a series of semithin sections from 34 kidney biopsies were studied retrospectively. Normal kidney from a nephrectomy specimen with a small renal adenocarcinoma served as a control. DNA fragmentation, expression of tissue transglutaminase II, BAX and BCL-2 were visualized immunohistochemically. In some renal biopsies, immunohistochemical staining for activated caspase 3 was performed. Proinflammatory markers (C-reactive protein, leukocytes), serum creatinine, creatinine clearance, total proteinuria, albuminuria, alpha(1)-microglobulin and IgG excretion were determined at the time of biopsy. Serum creatinine and total proteinuria were assessed 6 and 12 months after renal biopsy. RESULTS: Nuclei with different degrees of DNA fragmentation were mainly found in epithelial cells of tubules, but also in glomerular cells, regardless of the form of GN studied. Transglutaminase II expression was found only in cells with a strong staining for DNA fragmentation. DNA fragmentation localized to glomerular cells was more pronounced in proliferative than in non-proliferative forms of GN, being most abundant in patients with rapid progressive GN. Staining for activated caspase 3 in selected biopsies confirmed the presence of apoptosis. BAX and BCL-2 staining was detected within the same cells, but exhibited a different intracellular distribution. In proliferative GN, the extent of DNA damage in tubular epithelial cells significantly corresponds with the concentration of serum creatinine (p < 0.04) and with urinary excretion of alpha(1)-microglobulin (p < 0.01) at the time of biopsy. A significant correlation (p < 0.01) was seen between glomerular DNA fragmentation and follow-up total proteinuria 12 months after biopsy for proliferative forms of GN. The damaged glomerular area (e.g. mesangial sclerosis) significantly correlated with DNA fragmentation in proliferative, but not in nonproliferative GN at the time of biopsy. Furthermore, glomerular damaged showed a significant correlation with tubular DNA damage in proliferative GN. CONCLUSION: In glomerular cells, apoptosis may be important for the clearance of proliferating cells whereas in tubules, cell damage showed dependence on the degree of tubular injury mediated by inflammation and/or proteinuria. Although the degree of apoptosis in tubular cells correlates with serum creatinine in proliferative GN at the time of biopsy, it is of limited use to predict future renal function.

Adult↗
PubMed2006

[Recurrent urinary tract infections in women. Virulence of pathogens and host reaction].

The interactions of host-specific and microbial factors are responsible for recurrent urinary tract infections (rUTI). The anatomical properties of the female urogenital tract favor colonization by uropathogens. Local factors such as glucose concentration of the urine, stability of the lactobacilli population, the influence of estrogens, the activity of Tamm-Horsfall protein or of defensins, and disturbance of the systemic defense mechanisms dictate the course of an infection. The most prominent uropathogen is E. coli. It expresses various virulence factors including adhesions, toxins, iron uptake systems, and a capsule. It is still unclear if there are virulence factors characteristic for E. coli strains causing rUTI. The formation of intracellular reservoirs by invasion of uroepithelial cells by E. coli could be another, as yet little noticed cause for rUTI. Therefore, in cases of rUTI the application of intracellularly active antibiotics should be considered.

Animals↗
PubMed2005

Effect of L-methionine supplementation on plasma homocysteine and other free amino acids: a placebo-controlled double-blind cross-over study.

OBJECTIVE: The essential amino acid L-methionine is a potential compound in the prophylaxis of recurrent or relapsing urinary tract infection due to acidification of urine. As an intermediate of L-methionine metabolism, homocysteine is formed. The objective was to study the metabolism of L-methionine and homocysteine, and to assess whether there are differences between patients with chronic urinary tract infection and healthy control subjects. DESIGN: A randomized placebo-controlled double-blind intervention study with cross-over design. SETTING: Department of Nutritional Physiology, Institute of Nutrition in cooperation with the Department of Internal Medicine III, Friedrich Schiller University of Jena, Germany. SUBJECTS: Eight female patients with chronic urinary tract infection and 12 healthy women (controls). INTERVENTIONS: After a methionine-loading test, the volunteers received 500 mg L-methionine or a placebo three times daily for 4 weeks. MAIN OUTCOME MEASURES: Serum and urinary concentrations of methionine, homocysteine, cystathionine, cystine, serine, glycine and serum concentrations of vitamin B12, B6 and the state of folate. RESULTS: Homocysteine plasma concentrations increased from 9.4+/-2.7 micromol/l (patients) and 8.9+/-1.8 micromol/l (controls) in the placebo period to 11.2+/-4.1 micromol/l (P=0.031) and 11.0+/-2.3 micromol/l (P=0.000), respectively, during L-methionine supplementation. There were significant increases in serum methionine (53.6+/-22.0 micromol/l; P=0.003; n=20) and cystathionine (0.62+/-0.30 micromol/l; P=0.000; n=20) concentrations compared with the placebo period (33.0+/-12.0 and 0.30+/-0.10 micromol/l; n=20). Simultaneously, renal excretion of methionine and homocysteine was significantly higher during L-methionine intake. CONCLUSIONS: Despite an adequate vitamin status, the supplementation of 1500 mg of L-methionine daily significantly increases homocysteine plasma concentrations by an average of 2.0 micromol/l in patients and in control subjects. An optimal vitamin supplementation, especially with folate, might prevent such an increase.

Adult↗
PubMed2004

Correlation between blood group phenotype and virulence properties of Escherichia coli in patients with chronic urinary tract infection.

A predisposition to urinary tract infection (UTI) is associated with the expression of P1 as well as the presence of ABO blood group antigen on the boundary layer and with the secretor state. Infectious microorganisms interfere with specific molecules on epithelial cells, these are antigens of the P and ABO blood group system. The blood group phenotype was examined in 53 women (age 42 +/- 12 years) with chronic non-obstructive UTI. The diagnosis was established on the basis of clinical history as well as clinical laboratory and radiological findings. The ABO phenotype and the P1 antigen were analysed by anti-A and anti-B as well as anti-P1 serum. The Lewis phenotyping was performed by incubating erythrocytes with anti-Le(a) and anti-Le(b) serum. In all patients, the blood group status were investigated. The proportion of persons with B-phenotype was 23% (the incidence of this feature in the German population is 14.5%). P1 antigen was found in 76% patients. In comparison with P1 antigen-negative individuals, P1 antigen-positive persons have a longer disease history and suffer more frequently from symptomatic events as well as destructive renal changes. The Le (a)-antigen was detected in 82% and the Le (b)-phenotype was observed in 18% of patients. The blood group phenotypes (ABO, Lewis and P1 antigens) represent an interesting natural aspect of local defence system against the invasive efforts of uropathogens. Antigen structures on uroepithelial cells for example, the glycolipids of the P antigen, serve as receptors for adhesion of microorganisms.

ABO Blood-Group System↗
PubMed2004

[Interpretation of increased D-dimer values].

BACKGROUND: The determination of D-dimer concentration is an essential part in the diagnostic procedure of thromboembolic diseases, e.g. deep vein thrombosis, pulmonary embolism. D-dimers are the products of fibrin hydrolysis with elevated levels in fibrinolytic processes. QUESTION: In the clinical practice problems exist in the interpretation of increased D-dimer concentrations, especially without thromboembolic disease. Before starting further expensive imaging diagnostics other reasons (i.e. pregnancy, neoplasma, systemic inflammatory disease, advanced arteriosclerosis) should be considered in differential diagnosis. CONCLUSION: The determination of the concentration of D-dimers is involved in the diagnostic strategy in thromboembolic diseases. However, this parameter is not suited for routine screening. Its high predictive-negative value is proved for the exclusion of thrombosis or pulmonary embolism in case of negative test result. Since a range of diseases and physiological conditions lead to increased D-dimer values, a positive D-dimer result does not verify the diagnosis of thromboembolism.

Antifibrinolytic Agents↗
PubMed2004

Differential expression of beta-chemokines MCP-1 and RANTES and their receptors CCR1, CCR2, CCR5 in acute rejection and chronic allograft nephropathy of human renal allografts.

BACKGROUND: The beta-chemokines MCP-1 (CCL2) and RANTES (CCL5) have been shown to play important roles in acute renal transplant rejection (AR) and chronic allograft nephropathy (CAN). The potential relationship of expression of these chemokines, their chemokine receptors CCR1, CCR2, CCR5, and the cell populations of inflammatory infiltrate, histological and clinical diagnoses were investigated in biopsies at the time of AR and compared with biopsies of CAN. METHODS: In 24 renal transplant biopsies with AR (n = 15) and CAN (n = 9), the expression of MCP-1 and RANTES, their receptors CCR1, CCR2, and CCR5 and the infiltration with monocytes/macrophages and T cells were studied. RESULTS: As previously described, chemokine and chemokine receptor expression was found mainly in mononuclear cells infiltrating the interstitium and glomeruli. In the tubulointerstitial area and glomeruli the expression of MCP-1, RANTES, and their receptors correlated with an infiltration by monocytes/macrophages. Biopsies with CAN revealed a lower expression of MCP-1, RANTES, CCR1, CCR2 and CCR5 in tubulointerstitial cells, and a significantly lower infiltration with MRP14-positive monocytes/macrophages than biopsies with AR. In AR, MCP-1 and CCR1 showed a lower expression compared to RANTES, CCR2, and CCR5. CONCLUSIONS: The positive correlation between chemokines and chemokine receptors and infiltrating leukocytes during acute rejection, the lower but detectable expression of MCP-1, RANTES, CCR1, CCR2 and CCR5 in CAN, and the differences in the quantity of expression between the different chemokines and chemokine receptors point to a complex regulation of chemokine expression in renal allografts. Since chemokines are not only involved in inflammation but also in tissue regeneration, this could have impact on the development of CAN.

Adult↗
PubMed2004

Diabetes mellitus and dialysis.

Diabetes mellitus is increasing, and in some countries is the single most important cause, for end-stage renal disease. In general, primarily elderly patients on renal replacement therapy, are not only affected by diabetes-related long-term complications, but also frequently with a wide range of co-morbidities. Apart from cardiac complications, the patients are subject to a wide range of vascular (i.e. peripheral vascular disease, stroke) and infectious complications. In the past this has been reflected by a relatively poor survival rate on dialysis, and minimized chances to obtain renal transplantation. Today, several renal replacement strategies are available, including the main 3: hemodialysis, peritoneal dialysis or kidney transplantation. For patients with diabetes mellitus, hemodialysis is the most commonly used therapy. Each dialysis unit should achieve an optimal dialysis adequacy represented by a single pool Kt/V of at least 1.2. The most important independent predictor of patient survival with hemodialysis treatment is age. Other factors related to complications are left ventricular hypertrophy, arterial hypertension, hypervolaemia and chronic anemia. Moreover, medial arterial calcification, malnutrition, gastrointestinal disorders and dialysis against low potassium dialysate are related to increased morbidity and mortality as well. An integral part of treatment is the availability of good vascular access. The survival rates of fistulas show a nearly twofold higher rate of failure for synthetic grafts compared with arteriovenous fistulas. The role of peritoneal dialysis in renal replacement therapy in patients with diabetic nephropathy is well established and used world-wide. Most patients with residual renal function start with continuous ambulatory peritoneal dialysis (CAPD), but automated peritoneal dialysis can also be used. An unresolved problem associated with CAPD is the glucose absorption and caloric intake. The optimum adjustment of blood glucose values is made more difficult. Death rates of diabetic patients on peritoneal dialysis remain higher than in non-diabetics. The changes in peritoneal membrane thickness and vascular alterations in relationship to the duration of dialysis are caused mainly by glucose and glucose degradation products, such as advanced glycation endproduct (AGEs). Therefore, new peritoneal dialysis solutions are needed to reduce the complications and to delay a long-time function of the peritoneal membrane. Peritonitis remains still the major cause of discontinuation of dialysis but there is no increased risk in diabetic patients. Nevertheless, an integrative care of end-stage renal disease patients with diabetic nephropathy should be offered to the patient, starting on peritoneal dialysis and switch to hemodialysis if problems arise. During the whole time patients should be kept on the renal transplantation waiting list.

Diabetic Nephropathies↗
PubMed2003

[Validity of iohexol clearance in patients with chronic renal failure and normal renal function in comparison to (99m)Tc-DTPA-clearance].

BACKGROUND AND OBJECTIVE: The most common method used for testing dynamic renal function is creatinine clearance, but it has some limitations, e. g. variable muscle mass and tubular secretion of creatinine. The use of radionuclides as an exact method is limited in terms of availability, cost and time needed for examination. We compared the plasma clearance of iohexol with the established (99m)Tc-diethylenetriaminepentaacetate acid (DTPA) clearance. The aim of the present study was to validate iohexol clearance as a simple and suitable method for measuring to determine GFR with a comparable sensitivity to radioisotopic methods. METHODS: 120 patients (49 females, 71 males), mean age of 56 (range 20 to 84) years with normal renal function and different stages of renal failure, mean creatinine clearance of 61.6 +/- 44,9 (range 1.8 - 181.1) ml/min/1.73 m2 received a bolus injection of 10 ml iohexol, a non-ionic low osmolar x-ray contrast medium. Using the one-compartment model, plasma samples were taken after 150, 240 and 480 minutes. The total plasma disappearance of iohexol was measured by x-ray fluorescence analysis and the clearance was calculated. The (99m)Tc-DTPA clearance was determined in accordance with a standard protocol. RESULTS: A high correlation was found between the clearance of iohexol and (99m)Tc-DTPA (r = 0.95). The average deviation between Iohexol and (99m)Tc-DTPA clearance was 7.4 ml/min/1.73 m2. Allergic and nephrotoxic side effects were not observed. CONCLUSION: Iohexol clearance is a valid method for measuring GFR in patients at any stages of renal failure. It is easy to perform and inexpensive.

Adult↗
PubMed2003

Anti-C1q antibodies and antiendothelial cell antibodies in systemic lupus erythematosus - relationship with disease activity and renal involvement.

The aim of this study was to investigate the relationship between the presence and titre of antibodies against C1q (anti-C1q Ab) and disease activity and renal involvement in patients with systemic lupus erythematosus (SLE). Anti-C1q Ab were measured in 79 patients with SLE (70 women and 9 men; mean age 41.7 years; mean disease duration 8.4 years): 19 patients had active disease with lupus nephritis, 8 active disease without nephritis, 26 inactive disease with nephritis and 26 inactive disease without nephritis. Anti-dsDNA antibodies (EIA and immunofluorescence), antiendothelial cell antibodies (AECA) and complement levels (C3, C4, total haemolytic complement activity) were determined in parallel. Anti-C1q Ab were positive in 49%, anti-dsDNA Ab in 61% and AECA in 19% of the patients, respectively. Significantly higher titres of anti-C1q Ab were found in patients with active disease compared with those with inactive SLE ( P < 0.01). Serum levels of anti-C1q Ab showed a positive correlation with anti-dsDNA Ab and SLEDAI score ( P < 0.01) and a negative correlation with C3 ( P < 0.05), C4 ( P < 0.01) and CH50U ( P < 0.01). The presence of anti-C1q Ab was not different between patients with or without nephritis. In patients with ( P < 0.05) and without nephritis ( P < 0.01) the frequency of anti-C1q Ab was significantly higher in active patients compared with inactive patients. Both anti-C1q and anti-ds-DNA Ab were detectable in 74% of patients with active nephritis but only in 30% of all other patients ( P=0.001). None of the patients with active nephritis was negative for anti-C1q and anti-dsDNA Ab, whereas 37% of the patients without active nephritis were negative for both antibodies ( P < 0.01). Sensitivity, specificity, positive and negative predictive values for active lupus nephritis among SLE patients were 100%, 50%, 51.9% and 100% for anti-dsDNA Ab (EIA) and 74%, 70%, 57% and 89.4% for positive findings of both anti-dsDNA and anti-C1q Ab. The presence and titre of anti-C1q-Ab in SLE are related to disease activity. Absence of anti-dsDNA Ab excludes active nephritis; positive findings of both anti-dsDNA Ab and anti-C1q Ab are of relatively high specificity for active nephritis.

Adolescent↗
PubMed2002

The effects of prolonged physical exercise on renal function, electrolyte balance and muscle cell breakdown.

BACKGROUND: Postexercise proteinuria, hematuria and changes in serum electrolyte balance as well as increased levels of plasma indicators for muscle leakage are believed to be transient and of benign character. METHODS: A group of 51 healthy athletes took part in a 100 km race over 14.25 hours. All of them had to reach the finish together. Urine and blood samples were collected before (a) and immediately after running (b) as well as 6 hours after the race (c). RESULTS: The serum concentrations of potassium (4.8 +/- 0.5 (a) vs. 4.0 +/- 0.3 (c) mmol/l), protein (73.1 +/- 5.2 (a) vs. 71.1 +/- 3.9 (c) g/l) and albumin (44.0 +/- 2.85 (a) vs. 42.9 +/- 2.8 (c) g/l) decreased significantly (p < 0.0001, p < 0.05, p < 0.05, respectively) but remained within physiological ranges. The serum sodium concentration decreased immediately after the race (136.9 +/- 4.5 (a) vs. 131.1 +/- 2.4 (b) micromol/l, p < 0.0001). The fractional sodium excretion decreased 6 hours, but not immediately after the race (0.78 +/- 0.59 (a) vs. 0.48 +/- 0.82 (c), p < 0.05). Myoglobin (31.8 +/- 6.9 (a), 291.5 +/- 197.2 (b) and 182.2 +/- 135.3 (c) microg/l, p < 0.0001) and creatine kinase (1.13 +/- 0.45 (a), 10.76 +/- 6.9 (b) and 9.46 +/- 15.5 (c) pmol/l, p < 0.0001) increased dramatically. Troponin I was also significantly increased at finish (0.0186 +/- 0.0121 (a) vs. 0.0213 +/- 0.0165 (b) ng/ml, p < 0.05) and positively correlated with myoglobin and creatine kinase, but remained far below the pathologic range. Serum creatinine and urea remained almost unchanged. Glucosuria and hematuria occurred 6 hours after the run in 9.1% and 6.8%, respectively. The erythrocytes examined by phase-contrast microscopy were not damaged in terms of dysmorphic cells. Glomerular-type proteinuria was found in 11.4% of the participants 6 hours after the race. CONCLUSIONS: We conclude that long lasting, mild exertion is harmless for renal function, electrolyte balance and skeletal muscle as well as myocardial metabolism in healthy persons.

Adult↗
PubMed2001

[Fluoroquinolones: utilization in renal and urogenital tract infections].

The purpose of this review is to give an introduction in the class of fluoroquinolones, which has become a large class of substances, and to discuss the use, role, and place of these drugs in the treatment of urinary tract infections. The classification of the fluoroquinolones contains four groups. Antibacterial spectrum, pharmacokinetics, and indications are the main criteria. The various fluoroquinolones differ in their antibacterial spectrum, the antibacterial activity, and pharmacokinetic properties. Therefore selection, use, and dosage regime of the substances should be carried out under respective clinical requirements and medical points of view. The physician has to consider the specific indications for each substance in each individual case. Fluoroquinolones are suitable antibacterial agents for various urinary tract infections and are a valuable and useful addition to the antimicrobial treatment.

4-Quinolones↗
PubMed2001

Secretion of cytokines by uroepithelial cells stimulated by Escherichia coli and Citrobacter spp.

Urinary tract epithelial cells (T 24/83) are able to express interleukin (IL)-6, IL-8, platelet-derived growth factor (PDGF) and tumour necrosis factor-alpha, but not IL-1 beta, IL-2, IL-4 and IL-10 in response to an infection with uropathogenic bacteria. The process of cytokine secretion is time dependent, with a significant increase in the cytokine activity after 60 min. The expression of virulence factors of the bacteria does not seem to play a role. The interaction between bacterial products (e.g. lipopolysaccharide) and/or bacterial adhesion mediated by adhesins and specific receptor molecules of cell surfaces may be responsible for the activity of mediator protein expression in the epithelial cells. The release of PDGF and IL-8 was found to be higher when due to Escherichia coli HB 101 (rough form) than that caused by other bacterial strains. Citrobacter CB 3009 provoked the highest level of IL-6. The PDGF level correlated significantly with IL-6 and IL-8 values (P<0.001). There was a significant correlation between the time-dependent release of IL-6 and IL-8 (P<0.05). In epithelial cytokine response to bacterial infection, the reaction of the epithelial cells may modify themselves (e.g. internalization of bacteria) and the immuno-regulatory processes that are caused by infection and responsible for parenchymal injury.

Citrobacter↗
PubMed2001

High phosphorus intake only slightly affects serum minerals, urinary pyridinium crosslinks and renal function in young women.

OBJECTIVE: Assessment of the physiological effects of a diet rich in phosphorus in young women. DESIGN: Control period I--commercial basic diet containing 1700 mg P and 1500 mg Ca/day for 4 weeks. Supplementation period--a 6 week high-phosphorus period of 3008 mg P and 1995 mg Ca/day. Control period II--4 weeks washout with basic diet as in period I. SETTING: Institute of Nutritional Science, Friedrich Schiller University, Jena. SUBJECTS: Ten healthy women, aged 20-30y. INTERVENTIONS: Orange juice and tablets, containing supplements of Ca5(PO4)3OH and NaH2PO4, totalling 1436 mg elemental phosphorus per day. RESULTS: There was an increase of 10.7+/-13.7 pg/ml in serum PTH, a decrease of 0.6+/-0.6 ng/ml in serum osteocalcin, an increase of 73.6+/-136.6 nmol/mmol creatinine in urinary pyridinoline and of 19.3+/-36.0 nmol/ mmol creatinine in urinary deoxypyridinoline, and a decrease of 2.6+/-9.3 mg/l in urinary microalbumin. All changes were insignificant. There were no changes in serum levels of Ca, PO4 or Zn, in serum concentration of 1,25-(OH)2D3, and in urinary beta-2-microglobulin excretion. Phosphorus supplementation caused intestinal distress, soft stools or mild diarrhoea. CONCLUSIONS: In spite of a high phosphorus supplementation no significant changes in bone-related hormones, pyridinium crosslinks as markers of bone resorption and parameters of renal function in young women were found.

Adult↗
PubMed2001

Determination of erythrocyte antioxidant capacity in haemodialysis patients using electron paramagnetic resonance.

BACKGROUND: The increased oxidative stress of uraemia is caused both by an increased generation of oxygen-free radicals and a decrease of antioxidative forces. There are, however, conflicting data concerning disturbances of the radical-scavenging power of red blood cells (RBCs) in uraemic patients. METHODS: The antioxidant capacities of the RBCs of 10 haemodialysis (HD) patients and 10 controls were examined after treatment with 0.324 mM tert-butylhydroperoxide (t-BOOH) in phosphate-buffered saline at 37 degrees C using electron paramagnetic resonance (EPR) with 5,5-dimethylpyrroline-N-oxide (DMPO) as a spin trap and glutathione (GSH) regeneration as an indicator of hexose monophosphate shunt (HMPS) activity. EPR investigations were also done after pre-incubation with N-ethylmaleimide (NEM) to inhibit the GSH system. Furthermore, we determined the RBC redox state in 15 HD patients and 15 controls. RESULTS: There was no difference between HD patients and controls in the elimination of t-BOOH-generated free radicals in the RBCs. A more than 20-fold increase in radical concentration was observed after GSH trapping with NEM. In this case, we found a delayed decrease of the relative radical concentration in HD patients compared with controls with a significant difference after 7 min (2.2+/-0.26 vs 1.60+/-0.21; P=0.005) and after 10 min (1.82+/-0.41 vs 0.83+/-0.44; P=0.001). GSH regeneration via HMPS did not differ between the RBCs of HD patients (99.5+/-13.5 nmol/min x ml RBC) and those of the controls (94.2+/-16.9 nmol/min x ml RBC). There were no differences in the RBC concentrations of GSH, GSSG, NADP, NADPH, and in the GSH/GSSG and NADP/NADPH ratios between HD patients and controls. CONCLUSIONS: These data suggest a strong antioxidant potential in the GSH system of erythrocytes without any evidence of a disturbance in HD patients. The HMPS pathway also appears not to be impaired in the RBCs of HD patients. However, the slower radical elimination in the RBCs of HD patients after inhibition of GSH-depending radical scavengers as compared with controls indicates a defect in the antioxidant forces outside the GSH system, and could be one reason for the reduced lifespan of RBCs in HD patients.

Adult↗
PubMed2001

S-Fimbria-encoding determinant sfa(I) is located on pathogenicity island III(536) of uropathogenic Escherichia coli strain 536.

The sfa(I) determinant encoding the S-fimbrial adhesin of uropathogenic Escherichia coli strains was found to be located on a pathogenicity island of uropathogenic E. coli strain 536. This pathogenicity island, designated PAI III(536), is located at 5.6 min of the E. coli chromosome and covers a region of at least 37 kb between the tRNA locus thrW and yagU. As far as it has been determined, PAI III(536) also contains genes which code for components of a putative enterochelin siderophore system of E. coli and Salmonella spp. as well as for colicin V immunity. Several intact or nonfunctional mobility genes of bacteriophages and insertion sequence elements such as transposases and integrases are present on PAI III(536). The presence of known PAI III(536) sequences has been investigated in several wild-type E. coli isolates. The results demonstrate that the determinants of the members of the S-family of fimbrial adhesins may be located on a common pathogenicity island which, in E. coli strain 536, replaces a 40-kb DNA region which represents an E. coli K-12-specific genomic island.

Adhesins, Escherichia coli↗
PubMed2000

[Asymptomatic bacteriuria].

With the availability of methods to quantitate microbes in urine, one has come to recognize that a certain proportion of apparently healthy individuals have bacteria in their urine in the absence of any clinical symptoms. By definition, asymptomatic bacteriuria is present, if on 1, 2 or more consecutive occasions > 100,000 colony forming units/ml are found in aseptically collected midstream urine, granted that the same microorganism is isolated. Such asymptomatic bacteriuria is found in 2.7% of women aged between 15 and 24 years and increases to 20 to 50% in women above an age of 80 years. In men the prevalence of asymptomatic bacteriuria is considerably lower, but increases to 6 to 20% above the age of 80 years. The microbe most frequently involved in asymptomatic bacteriuria is Escherichia coli, which is characterized by the expression of multiple virulence factors. In this respect they differ from bacteria found in patients with lower or upper urinary tract infections. There is a consensus that in the absence of anatomical or functional abnormalities of the urinary tract asymptomatic bacteriuria per se does not lead to renal scarring, renal dysfunction, or hypertension. The overall prevalence of asymptomatic bacteriuria in pregnancy varies between 2 and 10% with the very small risk of an acute symptomatic episode of urinary tract infection in early pregnancy, but with a substantial risk (30 to 60%) during the last trimester. There is an association between asymptomatic bacteriuria and low birth weight. Asymptomatic bacteriurias are seen in 4 to 60% of immunosuppressed renal graft recipients. The incidence of asymptomatic bacteriuria is also high among patients with diabetes mellitus; the prevalence is approximately 3 fold higher in adult women (7.9 to 11.1%). In these patients asymptomatic bacteriuria does not carry a renal risk. Renal functional prognosis in uncomplicated asymptomatic bacteriuria is excellent. Therefore asymptomatic bacteriuria should be treated during pregnancy, after renal transplantation, prior to urological interventions and in patients with frequent episodes of symptomatic urinary tract infection.

Adolescent↗