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Evaluation of the usefulness of a novel injectable cephalosporin, E1040, and ceftazidime for management of complicated urinary tract infections caused by Pseudomonas aeruginosa and Proteus mirabilis by using the rat urolithiasis model.

A novel injectable cephalosporin, E1040, significantly eradicated Pseudomonas aeruginosa from the urine, in contrast to ceftazidime, in rats with complicated P. aeruginosa urinary tract infections associated with urinary stones, suggesting that E1040 is a prospective therapeutic agent in the management of refractory Pseudomonas urinary tract infections.

Animals↗

[Amyloidosis associated with chronic granulomatous disease in a patient with a renal transplant and recurrent urinary tract infections].

Chronic granulomatous disease is a group of syndromes which share a defect in a component of the phagocyte NADPH-oxidase complex. Without this enzyme activity, phagocytic cells cannot produce superoxide, peroxide, and other potent microbicidal radicals, and are less able to kill ingested pathogens. The clinical picture is characterised by recurrent life-threatening bacterial and fungal infections and abnormal tissue granuloma formation. On the other hand, amyloidosis is a systemic disease with renal involvement occurring in the majority of cases. Recurrent amyloidosis is a rare but well documented event in renal transplant recipients. However, graft loss secondary to amyloidosis has been noted infrequently. In addition, de novo amyloidosis has not been previously associated with graft loss. We report here a renal transplant recipient with chronic granulomatous disease and history of recurrent urinary tract infections, who developed nephrotic syndrome and progressive renal insufficiency secondary to de novo AA amyloidosis leading to graft loss 66 months after transplantation.

Amyloidosis↗

Effects of dietary calcium, magnesium and phosphorus on the formation of struvite stones in the urinary tract of rats.

After feeding various diets we studied the effects of dietary calcium, magnesium and phosphorus on the formation of struvite stones in rats with urinary tract infections, and also studied the effects of the administration of vitamin D3 and aluminium gel on stone formation. A low-magnesium diet decreased urinary magnesium and prevented stone formation, but a medium-calcium diet did not significantly decrease stone weight. A high-calcium diet decreased urinary phosphorus and inhibited stone formation. A high-calcium and high-phosphorus diet decreased urinary excretion of magnesium and inhibited stone formation. Although the administration of vitamin D3 did not inhibit stone formation, aluminium gel decreased the urinary level of phosphorus and prevented stone formation. A marked decrease in urinary magnesium and/or phosphorus may prevent struvite stone formation in rats with urinary tract infections.

Aluminum↗

[Prevention of infected urinary stones by urease inhibitor. IV. Treatment of infection stones in rats by a new hydroxamic acid and cefalexin].

We investigated the combined effectiveness of a new urease inhibitor, N-( pivaroyl ) glycinohydroxamic acid, with Cefalexin in the treatment of infection stones in rats. Combination therapy with the hydroxamic acid and Cefalexin inhibited bladder stone formation, and dissolved the stone dose dependently, while separate therapy was not significantly effective against stone formation or bacterial growth. This compound may become a useful medicine for the treatment of infection stones.

Animals↗

Unusual presentation of carcinoma of the vermiform appendix: a report of two cases.

Two unusual presentations of perforated mucoid adenocarcinoma of the appendix are described. One patient presented with a large periappendicular abscess that extended into the gluteal region, the other with a retroperitoneal abscess and abscesses in the right flank and groin. Recognition of the source of the abscess may be difficult but is essential for the prevention and elimination of the sepsis which may be life-threatening. The presence of mucin in the drained pus is highly suggestive for perforated bowel carcinoma. A high index of suspicion and the performance of prompt diagnostic procedures may bring early surgical treatment and better results.

Abscess↗

Characterization of endemic Providencia stuartii isolates from patients with urinary devices.

Providencia stuartii has emerged as a significant nosocomial urinary tract pathogen. An increase in the number of Providencia isolates from urine cultures prompted an investigation into the possibility of an outbreak due to this organism. A high proportion of patients studied had urinary devices. Four wards were screened at two time periods to ascertain the prevalence of Providencia stuartii in urine cultures. Biotype, serotype, antibiogram and plasmid content were determined for each Providencia isolate. Of 129 patients initially sampled 22.5% were found to harbor Providencia stuartii. Biotyping, serotyping and antibiograms indicated an epidemic strain was not present. Similar results were obtained when the wards were screened a second time, with 25.4% of urine cultures found to contain Providencia stuartii. By plasmid analysis the isolates could be grouped into one of ten profiles. A correlation could be made between urease activity and the presence of a large plasmid. No association however could be made between a particular plasmid profile and antibiogram. The data indicate that an epidemic strain of Providencia stuartii was not present. The source(s) of the endemic Providencia stuartii strains remain unknown.

Bacteriuria↗

Acute infectious arthritis. A review of patients with nongonococcal joint infections (with emphasis on therapy and prognosis).

The clinical course of 59 patients with acute nongonococcal septic arthritis has been reviewed with special emphasis on the changing bacterial spectrum in recent years. The results of treatment were dependent on various factors, including the specific microbial agent and host defenses. Treatment should include parenteral antibiotics and drainage with needle aspiration, except in hips which should be surgically drained. Successful therapy requires rapid initiation of treatment and ongoing assessment of adequacy of response.

Acute Disease↗