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PubMed1977

[The periurethral flora in female patients with recurrent urinary tract infection (UTI) (author's transl)].

In 52 girls and 38 women with recurrent nonobstructive UTI 529 bacterial samples were obtained from the periurethral area under the following conditions: no bacteriuria and no chemotherapy for at least 3 weeks before the examination. In 225 samples we found E. coli and enterococci as the most frequent potentially uropathogenic bacteria. In the periurethral region these were found approximately twice as frequently as in urologically normal persons. 36 (40%) of the patients had no further recurrences during the follow-up, though 107 (44%) of the swabs showed an abnormal bacterial colonization. 54 (60%) of the patients, many of them with very frequent recurrences, in only 118 (41%) of the obtained samples showed an abnormal periurethral flora. The findings suggest that the periurethral flora is not the most important factor in the pathogenesis of UTI.

Adolescent↗
PubMed1987

Development of nosocomial and iatrogenic urinary tract infections (UTI) following urological interventions. A prospective clinical study.

Development of nosocomial and iatrogenic UTI was investigated over 3 months period of time. Included were 140 patients following 228 instrumentations or endoscopical or surgical interventions. Of these 84 were carried out under antimicrobial medication. 30 UTIs developed 1-8 days after the various procedures (= 13.2%): 10% after TUR-B, 14% after TUR-P and ureteral instrumentation, 16% following cystoscopy and catheterisation. No significant difference was observed between: Males and females, patients with or without antimicrobial medication, younger and older patients and after long or short procedures. Indwelling catheters remain sterile for 3 days. Though antimicrobial prophylaxis did not significantly influence the generally low rate of infection it appeared as a trend that the elderly patient who requires repeated interventions and who suffers from additional diseases as diabetes, consuming tumours and renal insufficiency may benefit from medication.

Adult↗
PubMed1987

Cefuroxime axetil in the treatment of uncomplicated UTI: a comparison with cefaclor and augmentin.

Cefuroxime axetil (CAE) is an acetoxyethyl ester prodrug of cefuroxime. The efficacy and safety of cefuroxime axetil was studied in a randomized general practice trial in urological infections where cefuroxime axetil 250 mg b.d. was compared with amoxycillin/clavulanate (Augmentin, AUG) 375 mg t.d.s. A randomized trial was then performed in hospital outpatients, who received cefuroxime axetil 250 mg b.d. or cefaclor (CCL) 250 mg t.d.s. Of 140 clinically assessable patients, 108 were cured and 28 improved on cefuroxime axetil (97% success) compared with 75 cured and 13 improved out of 89 on Augmentin (99% success) and 31 cured and 7 improved out of 38 patients treated with cefaclor (97% success). Bacteriology was assessable in 101 patients given cefuroxime axetil (72% cleared), 61 of those given Augmentin (70% cleared) and 27 out of 28 (96%) given cefaclor. As expected, the predominant pathogen was E. coli, accounting for 61% of isolates overall. Drug-related adverse events occurred in 10% of patients given cefuroxime axetil, including diarrhoea in 4%. Eleven percent of patients given Augmentin suffered adverse events (5% diarrhoea) and 5% of those given cefaclor. Superinfections occurred in 4 cefaclor patients (2 Pseudomonas aeruginosa, 1 Candida, 1 E. coli) compared with 2 on cefuroxime axetil (1 Candida, 1 E. coli). Uncomplicated UTI accounted for 92% of cases in the G.P. trial and 82% of cases in the hospital trial. Cefuroxime axetil may be used safely and effectively to treat uncomplicated UTI at a dose of 250 mg b.d.

Adolescent↗
PubMed1998

Tolerance and pharmacokinetics of ciprofloxacin in the chick. Preliminary experience in subjects of pediatric age with urinary tract infections (UTI).

We studied the tolerance and pharmacokinetic parameters of ciprofloxacin in (2 mg/kg, i.v.) in 45 chicks. Serum concentrations of ciprofloxacin at various times of drawing (15 min, 30 min, 1 hr, 3 hr, 6 hr, 8 hr and 12 hr) peaked in the first 15 min with a trough after 6 hr, and were completely absent after 8 hr. We found no neurotoxic effects or behavioral changes. Encouraged by a good tolerance for this quinolone, we conducted a preliminary study concerning the therapeutic efficacy of ciprofloxacin in 8 subjects of pediatric age (8-14 years) with urinary tract infections (UTI) that are resistant to classic antibiotics. The results and normality of hematologic parameters, checked before and after therapy, allow us to recommend the monitored use of ciprofloxacin in children with UTI resulting from bacteria resistant to other antibiotics.

Administration, Oral↗
PubMedDate not supplied

Experiences on the efficacy and safety of nalidixic acid, oxolinic acid, cinoxacin and norfloxacin in the treatment of urinary tract infections (UTI).

The purpose of this study was to determine the effectiveness and tolerability of norfloxacin, cinoxacin and oxolinic acid in the treatment of urinary tract infections (UTI) in comparison to nalidixic acid. 125 patients were given the drugs in the appropriate doses for 10-14 days and 30 patients were treated for six weeks. Clinical, bacteriological, hematological and chemical checks were made on all patients before and after treatment. It was found that norfloxacin, cinoxacin and oxolinic acid are safe and effective against Escherichia coli, Klebsiella and Proteus, the commonly encountered organisms in urinary tract infections. The cure rate for norfloxacin was 93%, for cinoxacin 83%, for oxolinic acid 80% and for nalidixic acid 70% in the short course. However, these differences were not statistically significant. Oxolinic acid, cinoxacin and norfloxacin have the advantage over nalidixic acid of being administered only twice daily.

Adolescent↗
PubMed1992

Assessment of the UTI criteria for bacterial prostatitis in Japan.

A clinical study of a new oral fluoroquinolone was conducted in bacterial prostatitis for the assessment of the UTI criteria in Japan. It is concluded that evaluation of efficacy is possible after seven-day administration in acute bacterial prostatitis (ABP), and after 14-day administration in chronic bacterial prostatitis (CBP). In ABP, the cure evaluation can be done 14 days after the treatment period. Further studies on the pathogenicity of coagulase-negative Staphylococcus were found to be necessary. When isolates from expressed prostatic secretion (EPS) are employed before administration, isolation from VB3 should not be used for evaluation of efficacy.

Acute Disease↗
PubMed1994

Clinical evaluation of drug efficacy in UTI in men: the significance of bacterial elimination on day one.

With the purpose of assessing whether the effect of a drug at an early stage of administration could serve to predict efficacy at the end of drug treatment, a cephem antibiotic was administered for 5 days (days 0-4) by injection in males with complicated UTI. Results showed that the bacteriological effect on day 1 was reflected in the overall clinical efficacy on day 5. The activity of an antibacterial agent appeared to be reflected in the ability to eliminate bacteria 1 to 2 days after the start of drug administration.

Adolescent↗
PubMed2000

Antimicrobial resistance among urinary tract infection (UTI) isolates in Europe: results from the SENTRY Antimicrobial Surveillance Program 1997.

The SENTRY Antimicrobial Surveillance Program was established to monitor the occurrence and antimicrobial susceptibility of bacterial pathogens via an international network of sentinel hospitals. Twenty European hospitals referred a total of 887 urinary tract infection (UTI) isolates to the European SENTRY reference laboratory during the period October-December 1997. Ninety percent of the referred species were represented by Escherichia coli (52%), Enterococcus spp. (12%), Klebsiella spp. (7%), Proteus spp. (7%), Pseudomonas aeruginosa (7%), and Enterobacter spp. (5%). The susceptibility of E. coli isolates to penicillins was less than 60%, while almost all of the isolates were susceptible to piperacillin/tazobactam (98% susceptibility), cephalosporins (98%), and carbapenems (100%). Amikacin was the best aminoglycoside (99.8% susceptibility). The susceptibility to quinolones was only 88-89%, with highest levels of resistance observed for isolates from Portugal, Italy, England, The Netherlands, and some centers in France, Spain, and Poland. The susceptibility of Klebsiella spp. to the newer generations of cephalosporins was 82-95% and to the carbapenems 100%. Amikacin was again the best aminoglycoside (94% susceptibility). The susceptibility of Enterobacter spp. to any beta-lactam antibiotic was poor, except for the carbapenems (100% susceptibility) and cefepime (90% susceptibility), while the susceptibility to aminoglycosides was 80-89%. Proteus spp. showed complete susceptibility to cefepime, ceftriaxone, the carbapenems, and piperacillin/tazobactam, while the susceptibility of P. aeruginosa isolates was poor, with best results for the carbapenems (susceptibility 89%), piperacillin/tazobactam (susceptibility 84%), and amikacin and ticarcillin (susceptibility to both 80%). Enterococcus spp. showed the highest susceptibility to vancomycin (98%), teicoplanin (98%), and ampicillin (94%).

Candida↗
PubMed2005

UTY-specific TCR-transfer generates potential graft-versus-leukaemia effector T cells.

Immunotherapeutic approaches that target antigens that are differentially recognized on haematopoietic and non-haematopoietic cells may specifically enhance the graft-versus-leukaemia (GVL) effect of donor lymphocyte infusion. In this study, we have characterized a new HLA-B*5201-restricted epitope of the UTY gene. Unusually, presentation of this epitope was restricted to lymphoblasts. As a result, a T cell clone specific to this epitope recognized normal and malignant male B and T lymphoblasts, while showing little reactivity towards male HLA-B*5201+ fibroblasts. Transfer of its T cell receptor (TCR) into donor T cells led to the generation of large numbers of T cells, which acquired the specificity of the original clone, its avidity and the differential pattern of reactivity towards lymphoblasts and fibroblasts. Remarkably, the specific response of TCR-transferred T cells was significantly higher than that of the original clone. This is the first demonstration of the possibility to preserve the specific pattern of a T cell response to a differentially expressed antigen after TCR-transfer and to augment the amplitude of this response concomitantly. These results indicate that it may be feasible to enhance the GVL effect of donor lymphocyte infusions in lymphoproliferative malignancies by the transfer of TCRs specific to epitopes that are differentially recognized on lymphoblasts.

Cell Culture Techniques↗
PubMed2005

Nicotinic acid limitation regulates silencing of Candida adhesins during UTI.

The adherence of Candida glabrata to host cells is mediated, at least in part, by the EPA genes, a family of adhesins encoded at subtelomeric loci, where they are subject to transcriptional silencing. We show that normally silent EPA genes are expressed during murine urinary tract infection (UTI) and that the inducing signal is the limitation of nicotinic acid (NA), a precursor of nicotinamide adenine dinucleotide (NAD+). C. glabrata is an NA auxotroph, and NA-induced EPA expression is likely the result of a reduction in NAD+ availability for the NAD+-dependent histone deacetylase Sir2p. The adaptation of C. glabrata to the host, therefore, involves a loss of metabolic capacity and exploitation of the resulting auxotrophy to signal a particular host environment.

Animals↗
PubMed1990

Fosfomycin trometamol (Monuril) versus norfloxacin in single dose for adult female uncomplicated UTIs. Multicenter randomized, double-blind study.

The efficacy, tolerability and side effects of a 'single-dose' therapy for acute female lower UTIs in general practice with fosfomycin trometamol (3 g) or norfloxacin (800 mg) were compared in a randomized double-blind study. 89 patients were included in the trial; however, 36 (40.4%) did not present significant bacteriuria and were assessed mainly for tolerability. Of the 53, 28 patients in the fosfomycin trometamol group and 25 patients in the norfloxacin group, 21 (75%) had no bacteriuria at immediate follow-up after treatment with fosfomycin trometamol and 20 (84%) with norfloxacin. The tolerability of both drugs in single dose was absolute.

Adolescent↗
PubMed2005

Antibiogram pattern of isolates from UTI cases in Eastern part of Nepal.

The present study was conducted to study antibiogram pattern of isolates from urinary tract infection (UTI) cases at a referral hospital in Eastern Nepal. Of the total 2,799 of urine samples studied, 720 (25.7%) were positive for some kinds of bacterial agents. Escherichia coli was most predominant organism (59.0%) followed by Klebsiella sp. (12.6%), Pseudomonas aeruginosa (6.9%), Acinetobacter sp. (5.9%), Enterococcus sp. (4.2%) and others (2.6%). Antimicrobial susceptibility testing was done by Kirby-Bauer's disc diffusion method following National Committee for Clinical Laboratory Services (NCCLS) guidelines. Most strains of Esch. coli and Klebsiella sp. were resistant to Ampicillin and Ciprofloxacin. Ps. aeruginosa and Acinetobacter sp. showed relatively higher resistance to Aminoglycosides. These organisms were often multidrug resistant. Ps. aeruginosa showed 68.0% resistance to even Ceftazidime. For Enterococcus sp. Nitrofurantion and Gentamicin were the drugs of choice. Of the all antimicrobial agents tested, Ciprofloxacin showed most disappointing result.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Evaluation of a new method (Filtrachek-UTI) for the detection of bacteriuria].

The diagnostic effectiveness of a new test for the detection of bacteriuria (Filtrachek-UTI) was compared with Gram stain and semiquantitative culture in 955 urine samples. 276 of these were from inpatients (108 males and 168 females), and 677 from outpatients (206 males and 471 females). Overall 229 positive cultures were obtained. Taking the sample culture as the standard, the statistical parameters obtained were very low, particularly the sensitivity and the negative predictive value (75-89% sensitivity and 80-91% NPV in inpatients, and 67-92% sensitivity and 79-98% NPV in outpatients). Other problems of the method are the subjective interpretation, choluria or filter obliteration by the urine, high cost and an approximate false negative rate of 16%.

Adult↗
PubMed1976

[The immunofluorescence technique detecting antibody-coated bacteria for diagnosis of site of UTI (author's transl)].

The immunofluorescente technique detecting antibody-coated bacteria for diagnosis of site of UTI has been applied to 52 urine samples coming from : 11 patients with clinical diagnosis of pylonephritis, 21 infections of the lower urinary tract, 8 asymptomatic bacteriurias and 2 samples of urine obtained directly by pyelocentesis. The technique confirmed to be specific and sensible: strongly fluorescent germs were observed only in samples coming from pyelonephritis or urine from pyelocentesis. Repeatedly, from single samples were isolated more bacterial strains; only one of them was present in significant quantity. The some observation has been made also in 5 patients clinically affected with P.N., where 2 strains were isolated from each sample. In only one sample both strains were fluorescent, white in the remaining 4 samples the strain present in insignificative quantity was fluorescent. These observations, rather than a double localization (pyelo-renal and lower urinary tract) with different aetiologic agents, were interpreted to be the outcome of repeated antibiotic treatments. It is possible that they could have reduced the fluorescent "bacterial load" of the pyelo-renal region under significant number, simultaneously facilitating the emergence of superinfecting germs at the level of the lower urinary tract. We discuss the therapeutic involvements for a proper antibiotic treatment and the usefulness of flanking the test at the quantitative urine culture.

Antibodies, Bacterial↗