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At least 757 records · Page 42Linked to original sources
PubMed1987

Infection-induced urinary calculi and renal failure.

During 1974-1984 altogether 481 patients were treated for end-stage renal disease (ESRD). Eight patients, five women and three men, with chronic pyelonephritis as the primary cause of ESRD, had staghorn urinary calculi as a predisposing factor for renal failure. These eight patients were studied retrospectively concerning epidemiological and bacteriological aspects, the treatment of the stone disease, and the development of uraemia. Anatomical and metabolic abnormalities such as bladder outlet disturbances, primary hyperparathyroidism, phenacetin abuse or metabolic stone disease were found in six patients. The women had all been infected with Proteus mirabilis, whereas the men had been infected with various microorganisms. The average time taken for the development of ESRD, estimated from the first sign of renal impairment, was 7.4 +/- 2.9 (SD) years. Five patients had died before this study commenced. One of the patients still alive was on dialysis treatment. Two patients who were doing well without dialysis were stone free and had sterile urine after successful pyelolithotomy. It is concluded that the prevalence of infectious urinary calculi as a cause of uraemia in patients with ESRD is low. The time taken for uraemia to develop is short in these patients and they often have anatomical abnormalities. Proteus is commonly found in this group of patients. Patients with staghorn calculi, urinary tract infection and impairment of renal function are at risk of developing uraemia.

Aged↗
PubMed1993

Postoperative endophthalmitis resulting from prosthesis contamination in a monocular patient.

Monocular patients who wear an ocular prosthesis may harbor pathogenic conjunctival flora both in the socket and in the contralateral eye. They may therefore be at increased risk of developing endophthalmitis after intraocular procedures. We studied a monocular, prosthesis-wearing, 86-year-old man who underwent cataract extraction, subtotal transpupillary vitrectomy, and intraocular lens insertion. Fulminant endophthalmitis ensued postoperatively, and despite complete vitrectomy and administration of intraocular antibiotics, the eye lost light perception. Intravitreal as well as conjunctival cultures bilaterally grew Proteus mirabilis. The patient disclosed that he cleaned the prosthesis frequently because of discharge. We considered an association between this bacterial colonization and the risk of developing postoperative endophthalmitis and suggest prophylactic measures for treatment of monocular patients undergoing intraocular procedures.

Aged↗
PubMed1976

An outbreak of nosocomial Proteus rettgeri urinary tract infection.

Between December 1, 1971, and November 30, 1972, 11 patients on a single physical rehabilitation ward in a large St. Louis, Missouri, community hospital developed Proteus rettgeri urinary tract infections; P. rettgeri isolates from each patient were indole-negative and resistant in vitro to all antibiotics tested. Infected patients were more likely to have indwelling urinary tract catheters than were matched control patients, and all had previously received systemic antibiotic therapy. Retrospective epidemiologic investigation and microbiologic samplig at the time of the investigation failed to detect a common source of infection. Infected patients appeared to be the major reservoir of the epidemic strain, and indirect-contact transmission of the organism via nursing personnel probably occurred. Data collected from a prospective study suggested that placing catheterized patients in rooms that did not contain other catheterized patients may be an effective control measure.

Anti-Bacterial Agents↗
PubMed1989

Morphological lesions of the rat urinary tract induced by inoculation of mycoplasmas and other urinary tract pathogens.

The effects on the urinary tract after inoculation of Ureaplasma urealyticum into the rat bladder were evaluated and compared to that seen after Mycoplasma hominis, Escherichia coli and Proteus mirabilis inoculation. The inoculation of the urease-producing organisms P. mirabilis and U. urealyticum were associated with the formation of struvite bladder stones and predominantly hyperplastic lesions of the bladder. The P. mirabilis inoculated rats also displayed marked pyelonephritis. A similar but much less pronounced reaction also occurred in the kidneys of some of the U. urealyticum inoculated rats. P. mirabilis could frequently be recultured. In contrast, this was not possible with U. urealyticum, but the organism was detected by scanning electron microscopy 2 weeks after the inoculation. Inoculation of M. hominis was associated with a few mild lesions of the bladder, but inflammatory lesions were not present in the kidneys. The study confirms the potential of Ureaplasma to form struvite stones in rat urinary tract. It also demonstrates that it can induce inflammatory changes in both bladder and kidney of rats without concomitant stone formation.

Animals↗
PubMed1987

[Treatment of urinary tract infections with SolcoUrovac].

Urinary tract infections are among the most common infections found in women. If recurrences or reinfections become frequent treatment can be problematic. Immunisation of the patients by vaccinating them against urinary tract pathogens offers a possibility of managing these infections. In clinical trials we tested SolcoUrovac, a new vaccine to counteract bacterial pathogens, with regard to efficacy, frequency of recurrence, and tolerance. 113 of the 118 patients included in this study with bacteriuria (urine culture germ count greater than or equal to 10(5)/ml), had acute cystitis. 47 of these patients had recurring urinary tract infections. Follow-up examinations were conducted after 2, 3, 4, 5, 6 and 12 months. A urine culture assay was performed during each examination, as well as a relevant bacterial differentiation test and a urine sediment evaluation. Two to six weeks after termination of the vaccination series 72.6% of the patients were largely free from signs and symptoms. The rate of recurrence/reinfection dropped from 2.5 to 0.24 infections for a period of 12 months. After one year, 94 of the patients (80%) were still free from reinfection.

Adolescent↗
PubMed2006

Prospective study of individuals with long-term urinary catheters colonized with Proteus species.

OBJECTIVES: To characterize the variability in the times catheters take to block with encrustation in patients who have Proteus in their urinary flora, and to identify factors responsible for modulating the rate of catheter encrustation and blockage. PATIENTS AND METHODS: Twenty patients were followed prospectively for > or = 12 weeks, with a bacteriological analysis on weekly urine samples. The pH of the voided urine samples and the pH at which crystals formed in them (the nucleation pH) were determined. Catheters were collected and examined for bacterial biofilm and crystal deposition. RESULTS: The time that catheters took to block was 2-98 days. The mean pH of the urine voided by patients designated as slow encrusters (6.9) was not significantly different (P = 0.237) from that of rapid encrusters (7.2). However, patients whose catheters took longer to block had a significantly higher mean nucleation pH (8.1 vs 7.3, P = 0.002) and significantly higher mean safety margin between their nucleation pH and voided pH (1.17 pH units vs 0.13, P = 0.003). CONCLUSION: The variation in the rate of catheter encrustation between individuals infected with Proteus is a function of the difference between the voided pH and the nucleation pH of their urine. The value of nucleation pH of an individual's urine varies widely, suggesting it should be possible to devise strategies to increase this value and thus reduce the rate of encrustation in those with urinary tract colonization by urease-positive bacteria.

Biofilms↗
PubMed1988

Brain abscesses in neonates. A study of 30 cases.

Since the introduction of ultrasonography and computerized tomography (CT) scanning, brain abscesses are found more frequently in cases of neonatal meningitis and septicemia, particularly when the offending pathogen is Proteus. Thirty cases of brain abscess in neonates are reported, 27 of which were caused by Proteus species infections. Twenty infants had meningitis and 13 had septicemia. Most of the abscesses were enormous, and multiple abscesses were observed in 17 cases. The frontal region was involved in 22 cases (12 unilaterally and 10 bilaterally). The ventricles were enlarged on the first CT scan in 13 cases. The abscesses were treated by aspiration and antibiotics in 25 cases, and by antibiotics alone in five. A shunt for hydrocephalus was necessary in 14 infants. Four infants died, three from the initial illness and one from a shunt complication. Sixteen children have seizures. Subsequent intelligence quotient (IQ) testing was performed in 22 children: eight (36%) have an IQ at or above 80 and eight have an IQ of less than 60. In the 17 children followed for more than 2 years, the proportion with an IQ at or above 80 fell to 24% (four cases). The absence of initial seizures, sterile cerebrospinal fluid, normal ventricles on CT scans, and early aspiration of the abscess seem to be factors portending a better prognosis in terms of epilepsy and mental sequelae.

Anti-Bacterial Agents↗