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PubMedDate not supplied

Urinary trypsin inhibitor suppresses surgical stress-facilitated lung metastasis of murine colon 26-L5 carcinoma cells.

Recently, we have reported that surgical stress promoted the metastasis of murine colon carcinoma cells to the lung by inducing the expression of proteases such as matrix metalloprotease-9 (MMP-9) in lung tissue. Urinary trypsin inhibitor (UTI) is a serine protease inhibitor frequently used to treat pancreatitis and to improve the microcirculatory environment. The purpose of this study was to investigate the anti-metastatic properties of UTI in an animal model of surgical stress-induced cancer metastasis. The intraperitoneal administration of UTI after the intravenous injection of colon 26-L5 carcinoma (colon 26-L5) cells into mice subjected to surgical stress suppressed the enhancement of lung metastasis (p<0.05). Furthermore, we investigated the effect of UTI on tumor growth, adhesion to fibronectin, migration, invasion and enzymatic degradation in colon 26-L5. UTI reduced the invasive ability and the degradation by MMP-9 of gelatin substrate in colon 26-L5 cells. UTI may improve therapeutic efficacy in cancer patients after major surgery.

Animals↗
PubMedDate not supplied

A study for the improvement of the cytological urine examination performances in upper tract infection diagnosis.

Diagnosis of the location of upper and lower urinary tract infection (UTI) is necessary in defining the therapeutic conduct that has a different period and intensity according to the infection location and in prognosis. Many studies show the lack of clinical criteria peculiarity in revealing the different location of UTI. As a result, the correct location of the level in which UTI develops is the necessity of paraclinical investigations. Urinary sample examination, in which urinary sediment microscopy is essential, is a reliable technique in fast detection and localization of UTI. Finding, in pyuria context, the classic significant bacteriuria (> or = 10(5) CFU/ml) or lower value bacteriuria (< or = 10(4) CFU/ml) confirms the UTI diagnosis. The upper tract infection prognosis increases when leukocyte cylinders, characteristic for pyelonephritis, appear together with intact or degraded leukocytes, single or grouped. We settled an algorithm to examine the urine samples in order to: Concentrate and preserve the structural integrity of leukocytes and cylinders, examining the conventional urinary sediment Precisely identify and differentiate these elements by vital coloration (leukocyte peroxidase coloration and Sternheimer - Malbin coloration) to establish more accurate the UTI level. The vital coloration for leukocyte peroxidase has cytological specificity, confirming the pyuria and the cylinders that contain leukocytes (leukocytary, granular, mixed) and obviously ameliorates the reliability and reproducibility of the urinary sediment cytological exam.

Bacteriuria↗
PubMed2005

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2003). III. Secular changes in susceptibility].

The bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from 565 patients diagnosed as urinary tract infections (UTIs) in 14 institutions in Japan were collected between August 2003 and July 2004. The susceptibilities of these bacteria to various antimicrobial agents were examined. The bacteria were divided into 2 groups consisting of uncomplicated UTIs and complicated UTIs (with and without indwelling catheter) based on their isolation origins. The results were compared with those obtained between 1994 and 2002. The drug sensitivity of S. aureus in this year was similar to those in up to the previous years and S. aureus showed the best susceptibility to vancomycin. The drug sensitivity of E. faecalis in this year also was similar to those in up to the previous years. The drug sensitivity of E. coli in this year was generally good except penicillins and was similar to those in up to the previous years. Among cephems, cefozopran (CZOP) and cefpirome (CPR) showed the highest potency activity (MIC90: < or = 0.125 microg/mL). An antibacterial activity of cefotiam (CTM) was stable for 10 years and was fine (MIC0: < or = 0.5 microg/mL). The sensitivity of E. coli to carbapenems and carumonam (CRMN) also was good like to CZOP. The sensitivity of the complicated UTIs group to quinolones, however, has decreased after 2000 and it was suggested that the resistance to the drug has developed. Kiebsiella spp. showed a decrease in the susceptibility to some of cephems. The drugs indicating a big decrease in the sensitivity were cefazolin, CTM, cefaclor, and cefpodoxime. Imipenem, carbapenems, also indicated a decrease in the sensitivity. The susceptibility of the strain to the other drugs was similar to that in up to the previous years. Among them, CZOP maintained good susceptibility (MIC90: > or = 0.125 microg/mL against uncomplicated UTIs, 0.25 microg/mL against complicated UTIs) like meropenem. The drug sensitivity of P. aeruginosa was generally low and was not much different from that in up to the previous years.

Anti-Infective Agents↗
PubMedDate not supplied

Urinary tract infection and hyperbilirubinemia.

The aim of this study was to evaluate the incidence of urinary tract infection (UTI) in newborns with asymptomatic, unexplained indirect hyperbilirubinemia in the first two weeks of life. Jaundiced infants, otherwise clinically well, less than two weeks of ages, with a total bilirubin level above 15 mg/dl were eligible for the study. A bilirubin work-up including glucose-6-phosphate dehydrogenase (G-6 PD) level, as well as urinalysis and a urine culture were performed in all patients. Patients with UTI, defined as more than 10,000 colony-forming units per milliliter of a single pathogen obtained by bladder catheterization, were evaluated for sepsis. Renal function tests and renal ultrasound were performed in cases with UTI. During follow-up, voiding cystourethrogram (VCUG) and dimercaptosuccinic acid scintigraphy (DMSA) were performed as well. A total of 102 patients were enrolled. The bilirubin work-up of patients did not demonstrate any significant underlying disorder. None of the infants had a high direct bilirubin level. UTI was diagnosed in eight (8%) cases [Enterobacter aerogenes (3/8:38%), Enterococcus faecalis (2/8:25%), Klebsiella pneumoniae (2/8:25%) and Escherichia coli (1/8:12%)]. Of those eight patients, only four (50%) had pyuria. Bacteriuria was present in seven (88%) patients. The sepsis screen was negative in all but one case with a high C-reactive protein (CRP) level. None of the patients had a positive blood culture. Renal function tests were within normal levels in all patients. Renal ultrasound showed urinary tract abnormalities in three (38%) patients (hydronephrosis, n=1 and pelviectasis, n=2). VCUG was performed in all patients during the study period and one had unilateral grade 3-4 reflux, while only one patient had a diverticulum of the bladder. DMSA was performed in seven patients and none had renal scars. It is of importance that UTI can occur in asymptomatic, jaundiced infants even in the first week of life. Although it is well known that UTI is a common cause of prolonged jaundice, urine culture should be considered in the bilirubin work-up of infants older than three days of age with an unknown etiology.

Female↗
PubMed1990

Urinary tract infections in febrile infants younger than 8 weeks of age.

In this prospective study of 442 infants younger than 8 weeks of age who attended a pediatric emergency department with temperature greater than or equal to 100.6 degrees F (38.1 degrees C), urinary tract infections (UTIs) were found in 33 patients (7.5%), 2 of whom were bacteremic. Clinical and laboratory data were not helpful for identifying UTIs. Of the 33 patients with UTIs, 32 had urinalyses recorded; 16 were suggestive of a UTI (more than five white blood cells per high-power field or any bacteria present). Of the 16 infants with apparently normal urinalysis results, three had an emergency department diagnosis suggesting an alternative bacterial focus of infection. If the physician had decided on the basis of apparently normal urinalysis results to forgo obtaining a urine culture, more than half of the UTIs would have been missed. Bag-collected specimens were significantly more likely to yield indeterminate urine culture results than either catheter or suprapubic specimens. In addition, uncircumcised males were significantly more likely to have a UTI than circumcised boys. These results suggest that a suprapubic or catheter-obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants younger than 8 weeks of age, regardless of the urinalysis findings or another focus of presumed bacterial infection.

Bacteria↗
PubMed1989

[Therapeutic effects and influence on the urinary enzyme activity of human urinary trypsin inhibitor (urinastatin) in cases with acute renal failure--changes in the urinary activities of NAG and AAP].

We studied the therapeutic effects of human urinary trypsin inhibitor (UTI) in 5 cases with acute renal failure, resulting from traumatic shock in 1 case, post-operative shock in 2 cases, septic shock in 1 case, and dehydration in 1 case. We administered 300,000 u/day of UTI intravenously at the initial phase of acute renal failure for 7 days. We measured the activities of urinary N-acetyl-beta-D-glucosaminidase (NAG), alanine aminopeptidase (AAP) and the activities of serum beta-glucuronidase, PMN-elastase serially. As a control, we also studied same markers in 5 cases with acute renal failure without the administration of UTI. We could obtain the following results. 1) Urinary activities of NAG and AAP were already elevated markedly at the onset phase of acute renal failure. 2) The administration of UTI caused a significant decrease of the activities of NAG and AAP in the urine as compared with those in the controls. 3) The administration of UTI caused also the significant suppression of the activities of beta-glucuronidase and PMN-elastase in the serum. These results suggested that UTI has the protective effects on the tubular epithelial cell injuries in cases of acute renal failure.

Acetylglucosaminidase↗
PubMed1989

[Clinical experience with cefixime in urinary tract infections].

Cefixime (CFIX, Cefspan), a new oral cephem, was used in the treatment of urinary tract infections, and was evaluated for its therapeutic effectiveness and safety at the Department of Urology, Osaka Rosai Hospital. In a total 129 cases, to which daily doses of 200 mg of CFIX were divided into 2 doses and administered clinical efficacies in 35 cases of women with acute uncomplicated cystitis treated for 3.9 days in average and 79 cases with complicated urinary tract infections (UTIs) treated for 5.9 days in average were assessed, according to the Criteria for Evaluation of Clinical Efficacy of Antimicrobial Agents on UTI (3rd ed.) recommended by the Japan UTI Committee with our own minimum modifications. Mid term urine and catheterized urine were examined as urine samples for bacteriological evaluation. Clinical efficacies in 35 cases with acute uncomplicated cystitis were excellent in 24 (69%) and moderate in 11 (31%), with an overall clinical efficacy rate of 100%. Clinical efficacies in 79 patients with complicated UTIs were excellent in 24 (30%), moderate in 26 (33%) and poor in 29 (37%), with an overall clinical efficacy rate of 63%. All of the 35 bacterial strains isolated from urine samples of uncomplicated UTIs patients were totally eradicated by the CFIX treatment, while 85 strains (79%) were eradicated among 107 strains isolated from urine samples of complicated UTIs patients. Subjective adverse reactions were observed in 4 cases (3.1%) out of a total of 128 patients, as general malaise in 1 and lower abdominal symptoms in 3 were recorded. All of them disappeared after the termination of CFIX administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Urinary tract infections associated with otitis media in infants and children.

One hundred six infants and children with otitis media were screened for the incidence of urinary tract infections (UTI) by urine culture. Seventeen patients (16%) who had UTI were compared with the 80 patients with sterile urine for differences in host factors and laboratory features. The mean age, WBC counts, and ESR values were similar. Patients with UTI-associated otitis media had a higher incidence of hematuria. Prevalence of high (greater than or equal to 103 degrees F) fever was higher among the boys with UTI. However, because of the lack of definite clinical and laboratory clues to determine the presence or absence of UTI, urine culture is the only test to uncover otitis media patients with concomitant UTI.

Bacterial Infections↗
PubMed1989

Urinary tract infections in the elderly.

Urinary tract infection (UTI) is common in the elderly, with a prevalence of approximately 20% in women over 65 years of age. The elderly are predisposed to UTI by anatomic changes in the genitourinary system, by underlying disease, by instrumentation, and by residing in long-term care settings. Indwelling urinary catheters are a frequent cause of UTI, and catheter-associated sepsis is the most common cause of gram-negative sepsis in hospitals. Resistant organisms, prevalent in long-term care settings and hospitals, are increasingly responsible for UTI. Empiric antibiotic therapy has changed with the availability of new agents that cover resistant organisms. Oral antibiotics are appropriate for most UTIs; however, more serious infections require parenteral therapy. Length of antibiotic therapy is generally increased for UTI in the elderly.

Aged↗
PubMed1988

Effects of single-dose and three-day trimethoprim-sulfadiazine and amikacin treatment of induced Escherichia coli urinary tract infections in dogs.

Efficacy of single-dose and 3-day trimethoprim-sulfadiazine (TMS) and amikacin treatment regimens for induced Escherichia coli urinary tract infections (UTI) in dogs was evaluated. Using each regimen, effects of giving TMS combination or amikacin were compared in males and females, and the response of treated dogs was compared with that of nontreated controls. Response to treatment was evaluated, using results of quantitative urine cultures and urinalyses obtained on 4 occasions. Abacteriuria was identified by finding a lack of bacterial organisms in specimens collected for the initial and final posttherapy evaluations. Before treatments, magnitudes of bacteriuria were similar in all experimental groups, and UTI persisted in all nontreated dogs. Single-dose treatment regimens did not reliably eradicate UTI in males or females, whether amikacin or TMS was administered. Magnitude of bacteriuria often diminished immediately after single-dose treatment, and such reductions of bacteriuria persisted in 2 of 8 dogs. However, no male dogs and only 1 of 4 females became abacteriuric after a single-dose treatment regimen. The single female in which UTI was eradicated was treated with a single dose of amikacin. The 3-day TMS treatment regimen eradicated UTI in each of 4 females, but the 3-day amikacin treatment regimen resulted in abacteriuria in only 1 of 4 females. Three-day treatment regimens were not effective in male dogs, regardless of the antimicrobial drug used. Of the short-course treatments for canine UTI evaluated by this model, only 3-day TMS treatment of females was consistently effective.

Amikacin↗
PubMed1988

Urinary tract infections in the surgical patient.

Urinary tract infection (UTI) continues to be a common nosocomial infection. From a 2-year city-county hospital experience, 212 nosocomial UTI were identified in 153 patients from 3747 admissions. Mean age was 54 years; 102 were men. Foley catheterization was an associated factor in 129 patients (84%). UTI was caused by 40 different species of bacteria. In 28 infections (13%), the UTI was polymicrobial. Only nine patients had bacteremia. The bacteriology of the UTI depended on whether the patient had received systemic antibiotics previously during the hospitalization. Prior antibiotic administration increased the probability of Pseudomonas and Serratia as pathogens. Thus, patients that have had antibiotic therapy demonstrate a distribution of pathogens that are different from patients not receiving antibiotics, and a distribution different from the community-acquired UTI. Continued emphasis on the shorter duration and more judicious use of systemic antibiotics for both prophylaxis and therapy is warranted.

Adolescent↗
PubMed1987

Urinary pathogens and bacterial sensitivity in hospitalized urological patients based upon clinical aspects.

For a total of 396 hospitalized urological patients with complicated and/or hospital-acquired urinary tract infections (UTI) urinary pathogens with colony counts of 10(5)/ml or more were determined, several species were then subclassified by epidemiological markers. The minimal inhibitory concentrations (MIC) were measured using the agar dilution method for seven penicillins and for four penicillin combinations, for six oral and 14 parenteral cefalosporins, for three older and five newer quinolones, for two aminoglycosides, for two monobactams, for trimethoprim alone and in combination with sulfamethoxazole, for fosfomycin and for imipenem. Sensitivity and resistance of the strains were defined using breakpoints according to DIN 58.940 or analogous concentrations. The bacterial spectrum and the rate of resistant strains were correlated to clinical aspects pertaining to sexual status, age and underlying abnormalities within the urinary tract. There was a statistical difference in the frequency of E. coli and enterococci between patients with (complicated UTI) and without (uncomplicated UTI) abnormalities. Within the group of complicated UTI Proteus spp. were found significantly more often in patients with urolithiasis, Klebsiella spp. and staphylococci in patients with prostatic tumours (benign and malignant), enterococci in patients with prostatic and other tumours and E. coli in patients with abnormalities other than urolithiasis or tumours. Almost all antibiotics tested could be used in patients with uncomplicated UTI for empiric or calculated therapy if a rate of resistance of up to 10% is acceptable. In patients with urolithiasis only the newer acylaminopenicillins, the newer (fluoro-)quinolones, trimethoprim in combination with sulfamethoxazole, fosfomycin and imipenem fulfill this criterion. In order to treat complicated UTI with underlying tumours within the urinary tract empirically only piperacillin, apalcillin, imipenem and some of the newer quinolones (ofloxacin, ciprofloxacin and pefloxacin) could be recommended. The same was true for patients with indwelling catheters still present or recently removed.

Aminoglycosides↗
PubMed1986

Principles for targeted antibiotic use in urinary tract and enteric infections: a review with special emphasis on norfloxacin.

Urinary tract infections (UTI) and bacterial enteric infections are caused by the aerobic faecal flora. In UTI that flora is spread via the urethra to the urine and in some cases also to the renal parenchyma. Dissemination from urine to blood resulting in septicaemia may occur. Treatment of UTI should be given with antibiotics that cause minimal ecological disturbances in the faecal flora, i.e. emergence of resistance and selection of resistant species which may cause reinfections, should be avoided. If an antibiotic does not cause diarrhoea, poor absorption from the gastrointestinal tract is to be preferred when UTI is treated since it will result in a reduction of the reservoir of bacteria capable of reinfecting the patient post-treatment. In enteric infections, the aetiology is bacterial in about 60% of the cases. Such infections is by far more common in the third world where it is a problem mainly in neonates, infants and children but also for travellers. Antibiotic treatment of diarrhoea with antibiotics like doxycycline, ampicillin or co-trimoxazole may cause rapid selection of resistant faecal Enterobacteriaceae, which in many cases are multiple resistant. This is also the case if antibiotics are used to prevent travellers' diarrhoea. The 4-quinolones offer a new approach to treatment of both UTI and enteric infections. Their wide antibacterial spectrum against aerobes and lack of activity against anaerobes is in this respect optimal. Moreover, some of them, e.g. norfloxacin and ciprofloxacin, are poorly absorbed and will markedly reduce the faecal aerobes without selecting other bacterial species. Norfloxacin has a well proven efficacy in UTI but remains to be proven in enteric infections.

Bacterial Infections↗
PubMed1979

Trimethoprim in combination with a sulfonamide for oral treatment of canine urinary tract infections.

Trimethoprim, in combination with sulfadiazine or sulfamethoxazole was administered orally for 7 to 14 days to 84 dogs with urinary tract infections (UTI). The daily dosage of 26.4 mg/kg (12 mg/lb) was divided into 2 equal parts and administered at about 12-hour intervals. Response to treatment, based on negative urine culture during or after therapy, was 37 of 45 (82%) for UTI caused by Escherichia coli, 11 of 15 (73%) UTI caused by Proteus mirabilis, 8 of 12 (67%) UTI caused by Klebsiella pneumoniae, 6 of 6 (100%) UTI caused by Staphylococcus aureus, and 5 of 9 (56%) UTI caused by Streptococcus spp. These 5 species comprised 88% of the bacteria isolated from the dogs in this study.

Administration, Oral↗
PubMed1985

[Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1983). II. Background of patients].

We have been collected the causative isolates from patients with urinary tract infections (UTI) from the 8 institutions in Japan during 1980-1983. All strains isolated from UTI and recognized as etiologically responsible in each institution were sent to Bacteriology Laboratory of Juntendo University Hospital, Tokyo and the species of these strains were reidentified. We classified the UTI into 3 categories, simple, complicated without catheter and complicated with catheter. Of all strains isolated as etiologically responsible from cases of simple UTI, 65.3% were E. coli and 9.6%, Klebsiella spp. in 1983: these species accounted for about 75% of all isolates. Most frequently isolated from patients without catheter were E. coli 27.6% in 1983, followed in order by Pseudomonas spp. (20.9%), Gram-positive bacteria (16.7%), Serratia spp. (8.8%), Klebsiella spp. (8.0%) and Proteus spp. (7.1%). In complicated UTI with catheter, Pseudomonas spp. were most frequently isolated (25.6%), followed in order by Gram-positive bacteria (22.9%), Serratia spp. (15.0%), Proteus spp. (12.4%), Enterobacter spp. (6.0%) and Klebsiella spp. (6.0%). A remarkable difference, that is, Gram-positive bacteria, especially S. aureus, showed conspicuous increase of isolation between 1982 and 1983. Furthermore, we discussed the detailed analysis of patient background to clinical bacterial isolates from UTI in respect of patient distribution by sex, types of infections, distributions by age in male and female, interrelations between the species of bacterial isolates and types of infection and antimicrobial chemotherapy.

Administration, Oral↗
PubMed1985

[Clinical experience of norfloxacin (Baccidal) in the urological field].

The clinical effectiveness of a new synthetic pyridoncarboxylic acid derivative, norfloxacin (NFLX: Baccidal) was studied in the urological field. NFLX was given clinically to 50 patients with urogenital tract infections; 40 cases were acute simple cystitis and 10 cases were complicated UTI satisfied the criteria of the UTI committee. Thirty two bacterial strains were isolated from the group of acute simple cystitis and 10 bacterial strains were isolated from the group of complicated UTI. Susceptibility of NFLX by the method of distribution and disk sensitivity was 97% in the former group and 89% in the latter group. The overall clinical efficacy rate estimated by the criteria of the UTI committee in 32 cases with acute simple cystitis was 97% and in 10 cases with complicated UTI was 60%. The incidence of side effect was 8.0% (4/50). All of these side effects which were nausea, abdominal fullness and headache may be attributable to the administration of NFLX. No abnormal laboratory findings were observed except for elevation in GOT and GPT values in 1 case (4.0%), which returned to normal after NFLX treatment. Therefore NFLX is suggested to be a clinically useful and safe drug in the treatment of UTI.

Adult↗
PubMed1984

Urinary tract infection and blood P1 antigen: preliminary report.

A clinical study was made on the relationship between the blood type P1 antigen and urinary tract infection (UTI). The blood type P1 antigen could be detected in 3 out of 11 healthy Japanese volunteers (27.2%), and in 54% of the UTI patients as a whole. Classified by the type of infection, it could be detected in 3 out of 4 patients with upper UTI (75%) and in 11 out of 22 patients with lower UTI (50%). These incidences were higher than that of healthy volunteers, the difference being statistically significant. The relationship between the annual frequency of UTI and the positive detection of P1 antigen was examined. The patients who had been exposed to UTI twice or more a year proved to have a higher detection rate (61%), than the other group of patients, the difference being statistically significant. Two of the patients with E. coli detected as a clinical isolate proved to have the P1 antigen.

Blood Group Antigens↗
PubMed1984

[Bacterial adhesion to buccal epithelial cells as a permanent indicator of recurrent urinary tract infections].

Adhesion of a 3H-thymidine-labeled reference strain of enterococci to epithelial cells of buccal mucosa from 20 young female patients with rec. UTI (aged 3 to 15 years) and 19 urologically healthy girls was investigated. Bacterial attachment in children with rec. UTI was significantly higher statistically than in the healthy control group and did not show any alteration when tested separately during acute UTI (14 cases) and infection-free intervals (17 cases). There was no difference in adherence between patients with rec. UTI connected with diverse anomalies of the urinary tract (12 girls) and UTI patients without anomalies (8 girls). Within the patient group 3 cases under antimicrobial prophylaxis with co-trimoxazole showed bacterial adhesion similar to that in healthy controls. Our examination results lead to the assumption that attachment of enterococci to buccal epithelial cells can be used as a diagnostic criterion for rec. UTI.

Adolescent↗