Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CYSTITIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed2001

[Acute cystitis in women. Current microbial sensitivity in our setting].

INTRODUCTION AND OBJECTIVE: Acute cystitis is the most frequent symptomatic infection in females and the urological condition which results in more visits to the clinic. The empirical treatment commonly instituted requires a continuous update of local microbial susceptibility to keep resistance emergence under control and reduce costs. Our goal was to study the current susceptibility of all urological pathogens isolated in acute cystitis in female patients. MATERIAL AND METHODS: Prospective study on 218 cases of acute cystitis in females reported between March 2000 and November 2000 in Health Centres within our Health Care Area. Patients were distributed by age range also including other parameters such as history of previous cystitis and predisposing factors, clinical sings and symptoms, as well as isolated micro-organisms and their "in vitro" susceptibility and MIC (Minimum Inhibitory Concentration) against the anti-microbial agents most commonly used in the clinical practice. RESULTS: The larger age groups were 25-35 and 65-75 years. 162 cases were intermittent and 56 were repeat cystitis. Haematuria was present in 14% cases. The microbial spectrum was similar in all groups; overall E. coli was isolated in 82.1% cases, K. pneumonia in 6%, S. agalactiae 3.7%, E. faecalis 2.3%, P. mirabilis 1.8% etc. Resistance rates for E. coli were: 0.6% for cefixime, 1.1% for amoxycillin-clavulanate, 1.7% tobramycin, 2.8% fosfomycin, 3.3% nitrofurantoin, 18.4% ciprofloxacin, 19.6% norfloxacin, 22.3% pipemidic acid, 35.8% co-trimoxazol and 54.7% ampicillin. Repeat cystitis was more frequent in patients over 65 years with higher resistance rates mainly in the quinolones group (28.6% ciprofloxacin and 30.4% norfloxacin for E. coli). Mean MIC for ciprofloxacin with regard to E. coli was: 1.503 mcg/mL (range: 0.06-8) and 3.96 mcg/mL (range: 1-16) for amoxycillin-clavulanate. CONCLUSION: High E. coli resistance rates to quinolones are still persistent. Excellent susceptibility to amoxycillin-clavulanate, cefixime and aminoglycosides, which allows for their use in short-term treatment regimes. High resistance rates to urinary antiseptic agents such as co-trimoxazol and ampicillin, and low rates for agents such as fosfomycin and nitrofurantoin.

Acute Disease↗
PubMed2002

[Hemorrhagic cystitis caused by BK and JC polyomavirus in patients treated with bone marrow transplantation: clinical features and urologic management].

INTRODUCTION: Differential diagnosis of hematuria after bone marrow transplantation (B.M.T.) may include polyomavirus (BK and JC)-associated haemorrhagic cystitis. Many reports have implied BK virus as the major pathogen in the development of hemorrhagic cystitis after BMT. BK viruria is also associated with ureteric stenosis in renal allografts recipients. Viral urinary tract infections are uncommon in healthy individuals, but we can find them frequently in patients under immunosuppressive conditions. MATERIAL AND METHODS: Retrospective study of 123 consecutive B.M.T. recipients in the period from 1995 to 2000, evaluating those with polyomavirus-associated hemorrhagic cystitis. We present patient's characteristics, primary disease, clinical features, diagnosis aspects and treatment of these "hidden hosts of urinary tract". RESULTS: 7 patients (5.7% of B.M.T.) developed BK or JC virus-associated hemorrhagic cystitis; 3 men and 4 women; median patient age was 29 years (range 14 to 45 years). Bacterial, mycobacterial and parasitic urine cultivates had negative results in all of them. The clinical course was characterized by a late onset of haemorrhagic cystitis (days +30 to +132 after BMT). All 7 patients developed macroscopic haematuria (duration 3 to 30 days). In 6 cases Graft Versus Host Disease (G.V.H.D.) criteria were found. Ultrasonographic studies revealed diffuse thickening of bladder wall in 5 patients. Hematuria was managed by hyperhydratation, blood transfusions, transurethral catheter and evacuation of blood clots, continuous bladder irrigation, urine alkalinization and antiviral therapy. No other more aggressive measures were required to stop the bleeding. Only 1 case of transient elevated creatinine. CONCLUSIONS: Polyomavirus-associated haemorrhagic cystitis must be considered in differential diagnosis of hematuria in bone marrow transplantation recipients. Urological management, according with the severity and duration of hematuria, is frequently required.

Adolescent↗
PubMed1999

Increased urinary levels of adrenomedullin in patients with cystitis.

In this study, we examined urinary levels of adrenomedullin (AM) in 18 healthy volunteers and 18 patients with cystitis. We also compared urinary levels of AM in 11 patients with cystitis before and after antibiotic treatment. Urinary AM concentrations were measured by a radioimmunoassay specific for human AM. Urinary AM levels in patients with cystitis were significantly elevated compared with those of healthy volunteers and correlated positively with the number of urine leukocytes. By antibiotic treatment, urinary AM levels significantly decreased as compared with before the treatment. By RNA blot analysis of AM transcript, we detected significant levels of AM mRNA in canine urinary bladder and ureter. Intravenous administration of lipopolysaccharide elevated the AM mRNA level in the urinary bladder. These data suggest that infection and inflammation stimulate AM production in the urinary tract, which results in increased urinary AM levels in patients with cystitis. Based on these results, it is deduced that AM participates in the pathophysiology of cystitis, and its urinary level could be used as an index of the degree of cystitis.

Adrenomedullin↗
PubMed2000

Clinical features of tiaprofenic acid (surgam) associated cystitis and a study of risk factors for its development.

A case-control study was performed to describe the clinical course and identify risk factors predisposing to the development of tiaprofenic acid associated cystitis. Cases were identified from reports to the Australian Adverse Drug Reactions Advisory Committee and a two-year (1995-1996) national surveillance programme. Definition of a case was onset of symptoms of cystitis while taking tiaprofenic acid with pyuria (>10 WBC/microl) and/or hematuria (>10 RBC/microl), and no evidence of urinary tract infection. Definitions of "prescriber-matched" and "unmatched" controls were those who had been prescribed tiaprofenic acid by the same prescriber within 12 months of the case without developing cystitis or were identified from the databases of local pharmacies of the cases respectively. 81 of 109 identified cases and 109 of 184 potential controls completed a standardised interviewer-administered questionnaire. Median time between the commencement of tiaprofenic acid and symptom onset was 6. 3 months (range 0.1-47.1 months). Median interval between presentation to doctor and drug cessation was 3.0 months (range 0-24. 5 months). In half the patients, symptoms resolved within 14 days of ceasing therapy. Increasing age was a risk factor for the development of tiaprofenic-acid associated cystitis, age >70 years-odds ratio 3.2 (95% confidence interval 1.3-7.9) compared with age <55 years. Patients taking aspirin had a reduced risk (odds ratio 0.3, 95% confidence interval 0.1-0.9). Dose and amount of fluid consumed per day were not related to the risk of cystitis. Earlier recognition of tiaprofenic acid associated cystitis can potentially reduce the morbidity related to this condition. Apart from an increased risk among older patients, it is likely that this condition represents a drug reaction that cannot be predicted from clinical variables.

Adult↗
PubMed2006

Divergent pathway of intestinal metaplasia and cystitis glandularis of the urinary bladder.

Intestinal metaplasia has been proposed to be a precursor lesion of adenocarcinoma in the urinary bladder. CDX2 is a transcription factor that is encoded by a homeotype gene that plays an essential role in the differentiation and proliferation of intestinal epithelial cells. Hepatocyte-specific antigen (Hep) has also been shown to be a useful marker of intestinal metaplasia. Tissues from 46 patients, including 22 cases of intestinal metaplasia of the urinary bladder, 11 cases of typical cystitis glandularis, and 13 cases containing both lesions, were selected and immunohistochemical stains for CDX2, Hep, cytokeratin 20 (CK20), and cytokeratin 7 (CK7) were performed. Nuclear staining for CDX2 was observed in 29 of 35 (83%) cases of intestinal metaplasia of the urinary bladder. In contrast, nuclear staining for CDX2 was not observed in any case of typical cystitis glandularis; however, seven of 24 (29%) cases showed aberrant cytoplasmic expression in a mean of 37% of cells. CK20 was expressed in 28 of 35 (80%) cases of intestinal metaplasia, but was observed in only one of 24 (4%) cases of cystitis glandularis in 15% of cells. CK7 was expressed in only six of 35 (17%) cases of intestinal metaplasia, whereas expression of CK7 was observed in all cases (100%) of typical cystitis glandularis with a mean percentage of positively staining cells of 63%. The mean percentages of positively staining cells in intestinal metaplasia with CDX2, CK20, and CK7 were 55, 49, and 53%, respectively. All examples of both intestinal metaplasia and typical cystitis glandularis were uniformly negative for Hep. In the urinary bladder, intestinal metaplasia and typical cystitis glandularis have sharply contrasting immunoprofiles. Additionally, the absence of Hep staining in intestinal metaplasia of the urinary bladder, despite its morphologic resemblance to normal colonic mucosa and intestinal metaplasia in other organs, may signify the presence of unique metaplastic pathways in the urinary bladder.

Autoantigens↗
PubMed2000

Traditional Chinese medicine syndromes in women with frequently recurring cystitis: frequencies of syndromes and symptoms.

BACKGROUND: Frequently recurrent acute cystitis in adult women is common in Western medicine. In prophylactic treatment, women are treated between attacks of acute cystitis to prevent recurrences. A recent study has shown that acupuncture seems effective for prophylaxis. OBJECTIVES: To describe the frequency of traditional Chinese medicine (TCM) syndromes found in females vulnerable to recurrent cystitis, and which symptoms most often form the basis for TCM diagnoses made in this condition. METHODS: A descriptive study based on TCM diagnostic methods as used by experienced acupuncturists, and a questionnaire of symptoms used in TCM diagnostics. RESULTS: Of 61 women with frequently recurring cystitis, 90% were diagnosed as having either a Spleen/Kidney yang xu/qi xu (54%), or a Liver qi stagnation (36%). Only 10% fell in other diagnostic groups. Of all symptoms noted, only three differed in frequency between the two main diagnostic groups: feeling cold (29/33 vs. 13/22, P<0.05), feeling tired (25/33 vs. 4/22, P<0.001), and having a preference for sweets (10/33 vs. 2/22, P<0.05). CONCLUSION: Our findings have implications for TCM-based diagnostic work in females with recurrent cystitis, and also indicate that recurrent cystitis may be used as a case for further TCM research.

Acute Disease↗
PubMed1986

Association of BK viruria with hemorrhagic cystitis in recipients of bone marrow transplants.

Fifty-three recipients of bone marrow transplants were monitored prospectively for urinary excretion of human polyomaviruses by enzyme-linked immunosorbent assays of urinary supernatants and DNA hybridization assays of urinary cells. Excretion of BK virus was demonstrated in 47 percent of the transplant recipients and was the result of the reactivation of latent virus. Hemorrhagic cystitis of long duration (greater than or equal to 7 days) was associated with BK viruria. The disease occurred four times more frequently in patients who excreted BK virus than in those who did not, and the virus was identified in 55 percent of the urine specimens during episodes of cystitis as compared with 8 to 11 percent of the specimens during cystitis-free periods. BK viruria often preceded or coincided with the onset of the disease. Among 19 patients with BK viruria lasting seven days or longer, hemorrhagic cystitis occurred in 15. Occurrence of the disease was related to the source of marrow. The disease occurred in 50 percent of 38 recipients of allogeneic marrow and in 7 percent of 15 recipients of syngeneic or autologous marrow. Among recipients of allogeneic marrow, the disease was observed in 71 percent of the 21 patients excreting BK virus and in 24 percent of the 17 not excreting the virus. An association of BK virus with hemorrhagic cystitis was demonstrated in 16 of the 18 cases of the disease that were adequately characterized. We conclude that reactivation of BK virus may account for a substantial proportion of late-onset, long-lasting hemorrhagic cystitis in recipients of bone marrow transplants.

BK Virus↗
PubMed1995

Prevention of hemorrhagic cystitis following allogeneic bone marrow transplant preparative regimens with cyclophosphamide and busulfan: role of continuous bladder irrigation.

High dose cyclophosphamide and/or busulfan conditioning treatment of recipients of bone marrow transplants proved to be highly effective but associated with substantial and sometimes life threatening hemorrhagic cystitis. To prevent this complication, a prophylactic continuous bladder irrigation program was instituted in patients receiving cyclophosphamide and/or busulfan in preparation for bone marrow transplantation. Retrospective analysis of 199 patients who underwent allogeneic bone marrow transplantation revealed that continuous bladder irrigation significantly decreased the frequency of hemorrhagic cystitis in patients receiving busulfan and cyclophosphamide (continuous bladder irrigation 23% versus no bladder irrigation 53%, p < 0.004). There was no difference in the frequency of hemorrhagic cystitis between the different preparative regimens in patients who underwent continuous bladder irrigation. There was no relationship between the incidence of hemorrhagic cystitis and the severity of graft-versus-host disease or the time to engraftment. The duration of hemorrhagic cystitis and overall survival rates were similar in both groups, and there was no increase in complications related to catheterization. In general, continuous bladder irrigation was well tolerated, decreased the incidence of hemorrhagic cystitis and may be useful in bone marrow transplant patients.

Adolescent↗
PubMed1998

The efficacy of intravesical bacillus Calmette-Guerin in the treatment of interstitial cystitis: long-term followup.

PURPOSE: Interstitial cystitis is a severe debilitating bladder disease characterized by unrelenting pelvic pain and urinary frequency. A prospective, double-blind, placebo controlled study of the use of intravesical bacillus Calmette-Guerin (BCG) in the treatment of interstitial cystitis was recently completed with a mean followup of 8 months. Results demonstrated a 60% BCG response rate, compared to a 27% placebo response rate. We now report the long-term followup results of those patients who received intravesical BCG. MATERIALS AND METHODS: Subjects randomized to receive BCG were followed at routine intervals with questionnaires and voiding diaries identical to those in the blinded study. Adverse events were closely monitored in the treatment and followup phases of the study. Subject baseline values were compared to followup data. RESULTS: Of the BCG responders mean followup was 27 months (range 24 to 33), and 8 of 9 (89%) continue to have an excellent response in all parameters measured. The global interstitial cystitis survey improved 70%, daily voids decreased 31%, nocturia improved 54%, mean voided volume increased 61%, pelvic pain decreased 81%, vaginal pain decreased 71%, urgency decreased 71% and dysuria decreased 82%. Overall well-being improved 54% and the Rand-36 quality of life survey overall improved 64%. In 86% of the patients (6 of 7) dyspareunia resolved. Of the initial BCG nonresponders there was no significant difference in interstitial cystitis symptomatology from baseline to last followup, suggesting that BCG does not worsen interstitial cystitis symptoms. No long-term adverse events from BCG were noted. CONCLUSIONS: Intravesical Tice BCG is safe, effective and durable in the treatment of interstitial cystitis. Of those patients who received only 6 weekly treatments and responded favorably 89% continue to have an excellent response with followup ranging from 24 to 33 months.

Adjuvants, Immunologic↗
PubMed1999

Mast cells mediate the severity of experimental cystitis in mice.

PURPOSE: We hypothesized that experimental cystitis induced by substance P (SP) or E. coli lipopolysaccharide (LPS) would be less severe in mice rendered mast cell deficient by genetic manipulation. MATERIALS AND METHODS: Two strains of mast-cell deficient mice (WBB6F1- kitW/kitW-v or kitW/kitW-v and WCB6F1-Sl/Sld or Sl/Sld) and their congenic, normal (+/+) counterparts were used. Cystitis was induced in female mice by intravenous injection of SP (0.1 ml.; 10(-6) M) or E. coli LPS (0.1 ml.; 2 mg./ml.), and inflammation was assessed by Evans blue dye extravasation. In a separate group of kitW/kitW-v and congenic normal mice, cystitis was induced by intravesical infusion of SP (0.05 ml.; 10(-5) M) or E. coli LPS (0.05 ml.; 100 microg./ml.) and compared with intravesical pyrogen-free saline (0.05 ml.; 0.9%). Severity of cystitis was determined by histological evaluation of the bladder wall 24 hours after intravesical infusions. RESULTS: Intravenous SP or LPS stimulated increased plasma extravasation in congenic normal mice but not in mast cell-deficient mice. Intravesical SP or LPS resulted in increased edema, leukocytic infiltration, and hemorrhage within the bladder wall in congenic normal mice, but the only histological evidence of inflammation in the bladders of kitW/kitW-v mice was increased hemorrhage in response to LPS. CONCLUSIONS: This study indicates that mast cells modulate the inflammatory response of the bladder to SP and LPS in mice. Although clinical trials of the use of antihistamines to treat or prevent cystitis have not been successful, these results suggest that therapies directed toward preventing mast cell activation may yet prove effective in treating cystitis.

Animals↗
PubMed2003

Recent developments in the management of interstitial cystitis.

PURPOSE OF REVIEW: Interstitial cystitis, a great enigma of urology today, is a chronic sterile inflammatory disease of the bladder of unknown etiology characterized by urinary frequency, urgency, nocturia and suprapubic pain. Although there are plenty of theories, the etiology of the condition remains obscure. This review focuses on recently published literature on interstitial cystitis. RECENT FINDINGS: Several pathophysiological mechanisms have been proposed in the past few years including epithelial dysfunction, activation of mast cells, neurogenic inflammation, autoimmunity and occult infection. Evidence indicates that it is a heterogeneous syndrome and that the two subtypes, classic and nonulcer disease, represent different entities. The diagnosis is made by clinical and cystoscopic evaluation with hydrodistension and often with biopsy when other disorders are excluded. The National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases has developed criteria for clinical studies. There is a need for a noninvasive marker of interstitial cystitis. Antiproliferative factor as a urinary marker has shown promising results. The value of the bladder permeability test in interstitial cystitis needs further investigation. Many gynecologic conditions mimic the symptoms of interstitial cystitis. Multiple forms of therapy are available including self-care and dietary changes, medical and intravesical treatments, neuromodulation, multimodality treatment and surgical intervention. It is recommended that the most conservative treatments are used first and surgery should be regarded as the last resort. SUMMARY: Interstitial cystitis is a challenging disease of urology today. While causative factors remain unknown, treatment is based on empiricism. Intensive research may result in new and hopefully more effective treatments in the future.

Biomarkers↗
PubMed2003

Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study.

PURPOSE: The efficacy of sacral neuromodulation for the treatment of symptoms in patients with refractory interstitial cystitis was evaluated. MATERIALS AND METHODS: A total of 25 patients with a mean age of 47 years and refractory interstitial cystitis were prospectively evaluated with a trial of sacral nerve stimulation. Patients who demonstrated 50% improvement in frequency, nocturia, voided volume and average pain qualified for permanent sacral nerve stimulator implantation. Treatment success was measured by voiding diary, report of average pain, and response to the Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index. RESULTS: Of the 25 patients 17 qualified for permanent sacral nerve stimulator implantation. At an average of 14 months followup mean daytime frequency and nocturia improved from 17.1 to 8.7 and 4.5 to 1.1, respectively (p <0.01). Mean voided volume increased from 111 to 264 ml. (p <0.01). Report of average pain decreased from 5.8 to 1.6 points on a scale of 0 to 10 (p <0.01). Interstitial Cystitis Symptom and Problem Index scores decreased from 16.5 to 6.8 and 14.5 to 5.4, respectively (p <0.01). Of the 17 patients 16 (94%) with a permanent stimulator demonstrated sustained improvement in all parameters at the last postoperative visit. CONCLUSIONS: Results of this prospective clinical study demonstrate that sacral neuromodulation is a safe and effective treatment for the dysfunctional voiding and pelvic pain in patients with interstitial cystitis who are refractory to other forms of treatment.

Adult↗
PubMed2003

Treatment of radiation induced hemorrhagic cystitis with hyperbaric oxygen.

PURPOSE: Hemorrhagic cystitis can occur 6 months to 10 years after pelvic radiation therapy with moderate to severe persistent rates of hematuria as 3% to 5% after radiotherapy for pelvic malignancies. Current treatment modalities for hemorrhagic cystitis include oral and intravenous agents, intravesical therapy and selective embolization of the hypogastric arteries. Hyperbaric oxygen therapy is now a widely accepted treatment option for radiation induced hemorrhagic cystitis. We assess the efficacy of hyperbaric oxygen for treatment of hemorrhagic cystitis. MATERIAL AND METHODS: From May 1988 through March 2001, 62 patients with radiation induced hemorrhagic cystitis were treated with hyperbaric oxygen at our institution. Followup ranged from 10 to 120 months. The primary pathological conditions were prostate cancer (81%) and bladder cancer (10%). Mean patient age was 70 years (range 15 to 88). Mean time between completion of radiation therapy and onset of hematuria was 48 months (range 0 to 355). Patients received an average of 33 hyperbaric oxygen treatments (range 9 to 68). RESULTS: Of the 62 patients treated information on 57 was available for analysis. Of the 57 patients (86%) 49 experienced complete resolution or marked improvement of hematuria following hyperbaric oxygen treatment. Of the 8 patients who did not improve 4 received fewer than 40 hyperbaric oxygen treatments and 7 prematurely terminated treatment (medical co-morbidities 4, claustrophobia 2, temporary resolution of symptoms 1). CONCLUSIONS: Hyperbaric oxygen therapy for radiation induced hemorrhagic cystitis is an efficacious treatment modality for patients in whom other forms of management have failed.

Adolescent↗
PubMed2005

Risk of irritable bowel syndrome and depression in women with interstitial cystitis: a case-control study.

PURPOSE: We determined the risk of irritable bowel syndrome and depression in women with interstitial cystitis. MATERIALS AND METHODS: Cases consisted of 46 women with newly diagnosed interstitial cystitis. The control group consisted of 46 women presenting for an annual gynecologic examination. Data were collected using standardized, validated questionnaires. RESULTS: The 2 groups were similar with respect to age, race, parity, previous pelvic surgery and postmenopausal hormone use. Compared with controls patients with interstitial cystitis were more likely to be diagnosed with irritable bowel syndrome (OR 11, 95% CI 2.7 to 52, p <0.001) and depression (OR 3.97, 95% CI 1.17 to 14.1, p <0.05). In the interstitial cystitis group when we compared women with and without depression, we noted that women with depression were significantly more likely to complain of bladder pain, nocturia, abdominal pain and other bowel symptoms. CONCLUSIONS: The association of irritable bowel syndrome and depression appears to be greater in women with interstitial cystitis than in controls. Additionally, it appears that pain of bladder or bowel origin is a significant cause of depression in women with interstitial cystitis.

Adult↗
PubMed1998

Alternate occurrence of allergic disease and an unusual form of interstitial cystitis.

BACKGROUND: It has been postulated that interstitial cystitis can be induced by an allergy. This is partly based on the observation that many patients with interstitial cystitis also have allergic diseases. In this study, an allergic evaluation was conducted on patients with interstitial cystitis complicated by bronchial asthma, a typical allergic disease. METHODS: Clinical histories were obtained and biopsy specimens from the vesical walls of the study patients were examined histologically. Cutaneous tests and IgE radioallergosorbent tests (RAST) were performed. Further, intravesical provocation tests were carried out using IgE RAST-positive antigens, and histamine release assays were performed on the vesical biopsy specimens using anti-IgE antibodies. RESULTS: Five of 6 patients alternately exhibited symptoms of allergic disease and bladder symptoms. The eosinophil and mast cell counts in the vesical biopsy specimens of these 5 patients were increased. Furthermore, an intravesical provocation test performed using the IgE RAST-positive antigen was positive in 4 patients. The mean vesical biopsy specimen histamine release was 17.7% for patients with interstitial cystitis with bronchial asthma which was significantly higher than that for interstitial cystitis patients without bronchial asthma (8.9%) or the control group (4.5%). The prognosis of patients with interstitial cystitis with allergic complications was relatively good. CONCLUSION: Patients with bronchial asthma exhibited hypersensitivity both generally and locally in the bladder. The alternation phenomenon was observed between the hypersensitive organs.

Adult↗
PubMed1987

Comparison of O antigen-specific urinary immunoglobulins to Escherichia coli in normal women and women prone to Escherichia coli cystitis.

The enzyme-linked immunosorbent assay (ELISA) measured urine and serum levels of O antigen-specific IgA against Escherichia coli in five women prone to recurrent Esch. coli cystitis and in 20 normal women. Serial urine and serum samples were taken from the five women during Esch. coli infections and during uninfected intervals, while a single urine and serum sample was obtained from the 20 normal women. Elevation of any class of serum immunoglobulins for patients with uncomplicated Esch. coli cystitis was absent. A local antigen-specific immunological response, predominantly of the IgA class, was present during Esch. coli cystitis. There was no significant difference (P greater than 0.1) in the urinary or serum levels of any class of immunoglobulins between the recurrent cystitis group when uninfected and the normal women. There was a significant increase (P less than 0.001) in the levels of urinary IgA and secretory IgA during Esch. coli cystitis as compared with the same women when uninfected or with normal women. A deficiency in the local immunological response of women prone to recurrent Esch. coli cystitis is not supported by our data.

Adolescent↗
PubMed2005

Bacterial characteristics in relation to clinical source of Escherichia coli isolates from women with acute cystitis or pyelonephritis and uninfected women.

Characteristics differentiating Escherichia coli strains that cause cystitis or pyelonephritis from fecal E. coli remain incompletely defined, particularly among adult women in the United States. Accordingly, phylogenetic group, O antigens, and virulence factors (VFs) were analyzed among 329 E. coli isolates from the mid-to-late 1990s from women in the United States with acute pyelonephritis (n = 170), cystitis (n = 83), or no infection (fecal; n = 76). Compared with fecal and cystitis isolates, pyelonephritis isolates exhibited a greater prevalence of phylogenetic group B2, most virulence-associated O antigens, and most VFs and had higher VF scores. In contrast, cystitis and fecal isolates differed minimally. By stepwise multivariable logistic regression, significant (P < or = 0.015) predictors of cystitis and/or pyelonephritis (versus fecal) included afa/dra (Dr-binding adhesins), ibeA (invasion of brain endothelium), iha (putative adhesin-siderophore), malX (pathogenicity island marker), the O75 antigen, papEF (P fimbriae), papG allele II (P adhesin variant), group B2, and sfa/foc (S and F1C fimbriae). However, virulence profiles overlapped considerably among source groups and varied greatly within each group. E. coli "clonal group A" (CGA) and the O2:K5/K7:H1 and O75:K+ clonal groups were significantly associated with cystitis and/or pyelonephritis. These findings identify potential vaccine targets, suggest that urovirulence is multiply determined, and confirm the urovirulence of specific E. coli clonal groups, including recently recognized CGA.

Acute Disease↗
PubMed2003

Pregnancy outcomes following the diagnosis of interstitial cystitis.

OBJECTIVE: To describe the outcome of pregnancy in patients treated for interstitial cystitis. METHODS: Over a 4-year period, 12 patients with interstitial cystitis who had one course of intravesical dimethyl sulphoxide (DMSO) therapy for interstitial cystitis were studied. Information on the effects of the treatment-to-conception interval, symptom control during pregnancy and immediately post partum, other pregnancy events and pregnancy outcome were collected. RESULTS: The mean age was 32 years (SD = 5.4), and 6 (50%) were nulliparous. Fifty-eight percent of the women presented with combined urinary and pain symptoms, 25% with a pain symptom only and 17% with a urinary symptom only. Eleven women had 1 course (6 doses) of DMSO therapy. Symptom relief was maintained during pregnancy in almost all the women. The mean interval from diagnosis of interstitial cystitis to the first day of the last menstrual cycle preceding all pregnancies beyond 28 weeks was 19.3 months (SD = 14.7). This interval was 6 months or less for 2 pregnancies that were terminated on account of symptoms attributable to interstitial cystitis. Thirteen healthy babies were delivered. CONCLUSION: Pregnancy outcomes appear good following treatment for interstitial cystitis with 1 course of intravesical DMSO.

Adult↗