[On the method of clinical tests of antibacterial drugs for acute cystitis. Report I. Natural healing, test period and dosage (author's transl)].
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Acute Disease↗
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A review of adenoviruses in the etiology of acute hemorrhagic cystitis.
In a comparison of children with acute hemorrhagic cystitis it was noted that 51 per cent of those in Sendai, Japan and 23 per cent of those in Chicago, Illinois had adenoviruria during their illness. These 2 populations are the only ones in which the disease has been studied and reported. In both populations male outnumbered female patients, with a ratio of 3.4 to 1 in Japanese children and 2.3 to 1 in American children. Adenovirus type 11 was isolated exclusively in both studies, with the exception of 2 American children who had adenovirus type 21 in the urine. While the Japanese children experienced their illnesses for approximately 2 weeks American children had symptoms for only 4 to 5 days. Virus shedding continued throughout the illness in both populations. The adenovirus 11 strains from American children were antigenically similar to the prototype adenovirus type 11 strain as measured by cross hemagglutination-inhibition procedures. Adenovirus antigen was identified by immunofluorescence in exfoliated bladder epithelial cells from patients with acute hemorrhagic cystitis. Studies to date indicate that adenovirus type 11 is the etiologic agent in some but not all pediatric cases of acute hemorrhagic cystitis.
Acute Disease↗
[Clinical investigation on a new penicillin derivative, bacampicillin (author's transl)].
A clinical investigation was carried out on a new penicillin derivative, bacampicillin with the following results. (1) Clinical effect--Bacampicillin was administered orally to 18 patients with acute simple cystitis, acute simple pyelonephritis, chronic prostatitis and acute gonorrhoic urethritis. Daily doses ranged from 750 mg to 1,000 mg. The administration continued for 4 to 14 days. Clinical effect was excellent in 10 patients and good in 5 patients. (2) Side effect--Side effects were noticed in 4 patients, one was allergic eruption and other 3 were gastralgia. In a patient the drug was discontinued to administer.
Adult↗
Clinical evaluation of pivmecillinam in acute simple cystitis: a comparative study with amoxycillin by a randomized double-blind technique.
The comparative efficacy of pivmecillinam and amoxycillin in 243 patients with acute simple cystitis was determined in a randomized double-blind trial. Pivmecillinam was found to be significantly more effective on both clinical and bacteriological grounds. The superiority of pivmecillinam was primarily due to its efficacy in infections due to ampicillin resistant Escherichia coli. Fewer side effects were reported in patients who received pivmecillinam.
Acute Disease↗
Quality-of-care assessment. I. Outpatient management of acute bacterial cystitis as the model.
A study was undertaken to determine whether a process audit of outpatient medical care would correlate significantly with the outcomes of care and thus prove to be a valid method for assessing the quality of medical care in the outpatient setting. Acute bacterial cystitis in women was selected as the model for study. A series of 42 cases was reviewed by retrospective analysis of patient records supplemented by follow-up interviews and collection of a follow-up urine culture from each patient to document the outcome of treatment. No positive association was demonstrated between the processes for satisfactory care selected by the expert criteria committee and the observed outcomes. Reasons for this failure in the present study and for deficiencies of the process audit method in general are discussed.
Acute Disease↗
[Clinical experience with S-6436 in patients with urinary tract infections (author's transl)].
Forty eight patients with urinary tract infections including a case of acute prostatitis were treated with S-6436 and the following results were obtained: 1. Thirty eight patients with acute cystitis resulted in 19 excellent, 15 good and 4 poor with effectiveness rate of 89.5%. 2. Ten patients with complicated urinary tract infections resulted in 1 excellent, 5 good and 4 poor with effectiveness rate of 60%. 3. Infecting organisms from 38 patients with acute cystitis were occupied by 28 strains of E. coli. The sensitivity rate of the infecting organisms to cephalexin was 96.4%. 4. In a few cases (6.25%) side effects of S-6436 were observed. 5. S-6436 will be one of the good first choice antibiotics for acute cystitis.
Acute Disease↗
Targeting the Disease Response With NlpD and LytM for Effective Nonantibiotic Treatment of Urinary Tract Infections.
BACKGROUND: Finding new ways of treating bacterial infections is essential. The NlpD protein, which inhibits RNA polymerase II (Pol II), has shown therapeutic efficacy against urinary tract infection. This study investigated the mechanism of Pol II inhibition and protection by NlpD and its LytM peptide. METHODS: Recombinant NlpD and LytM were screened for interactions with constituents of the Pol II complex, using AlphaFold predictions and protein interaction technology. Treatment effects were quantified in infected tissues and regulated host response pathways identified by genome-wide transcriptomics analysis in models of acute pyelonephritis and acute cystitis in Irf3-/- and Asc-/- mice, respectively. RESULTS: LytM was shown to interact with constituents of the Pol II multiprotein complex, inhibiting the CDK12 kinase from phosphorylating the Pol II subunit RPB1 and disrupting Pol II complex formation by interfering with the interaction between PAF1C and RPB1. The protection by LytM against acute pyelonephritis was accompanied by a reduction in gene expression in infected kidneys from >1900 significantly regulated genes (fold change >6) in the placebo group to about 150 in LytM-treated mice. The inhibition of gene expression in infected kidneys particularly targeted the excessive innate immune response. A similar effect was observed in acute cystitis. Bacterial clearance was accelerated in both model by LytM treatment, with effects against antibiotic-sensitive and resistant Escherichia coli strains. CONCLUSIONS: The results suggest that inhibiting the disease response of the host, using NlpD or LytM, may offer an efficient alternative to antibiotics in these models.
Animals↗
Adhesion to normal human uroepithelial cells of Escherichia coli from children with various forms of urinary tract infection.
The ability to adhere to normal human uroepithelial cells was compared for Escherichia coli strains isolated from the urine of girls with acute pyelonephritis, acute cystitis, or asymptomatic bacteriuria, and from the stools of school children without bacteriuria. Strains from those with acute pyelonephritis had high adhesive ability, whereas strains from those with acute cystitis had intermediate and strains from girls with asymptomatic bacteriuria or from normal feces had low adhesive ability. Strains of serogroup O4K12 had good adherence regardless of origin. E. coli of the eight O groups commonly found in patients with acute pyelonephritis adhered more than did strains of other O groups. Spontaneously agglutinating strains had less adhesive ability than did the O-typable ones.
Acute Disease↗
[Clinical evaluation of S-6436 in acute simple cystitis: A double blind comparative study of S-6436 and cephalexin (author's transl)].
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Acute Disease↗
Acute hemorrhagic cystitis. Industrial exposure to the pesticide chlordimeform.
An outbreak of hematuria occurred from May 20 to May 23, 1975, among employees of a chemical packaging plant. Nine of 22 workers who packaged the insecticide chlordimeform in a separate shed became severely ill with abdominal pain, dysuria, urgency to void, or hematuria. None of 18 persons who worked in other areas of the plant were affected. Four additional workers who had packaged the chemical during the previous year had a history of similar symptoms. Bladder biopsy specimens from three affected persons showed severe hemorrhagic cystitis; chlordimeform and 2-methyl-4-chloroaniline, a metabolite of chlordimeform, were present in urine specimens collected three days after exposure. The illness lasted from one week to two months; the workers recovered completely. Chlordimeform that was injected subcutaneously into three cats produced similar, though less severe, changes in the bladders of two animals.
Acute Disease↗
[Clinical experience with pivmecillinam tablets (Melicin tablets 'Takeda') for acute simple cystitis (author's transl)].
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Adolescent↗
Acute haemorrhagic cystitis and glomerulonephritis.
Two patients presented with macroscopic haematuria and dysuria. Cytoscopic examination showed haemorrhagic cystitis. The findings of casts in the urine and of impaired renal function led to renal biopsies. These showed glomerulonephritis with deposits of IgA in the mesangium. No evidence of viral infection was found. A third patient diagnosed on biopsy 9 years previously as having focal glomerulonephritis developed gross haematuria and dysuria. Cystoscopy revealed haemorrhagic cystitis, and deposits of immunoglobulins were present in the bladder wall. It is suggested that haemorrhagic cystitis may occur as part of a syndrome with glomerulonephritis and may be due to an immunological mechanism.
Adolescent↗
[Antibody-coated bacteria and localization of urinary tract infection].
The distinction between upper and lower urinary tract infection (UTI) is of great help in the management and treatment of these conditions. The antibody-coating technique was used to investigate urine of patients with nephrostomies, chronic and acute pyelonephritis, chronic and acute cystitis, of male patients with dysuria and significant bacteriuria and of female patients with indwelling catheters. Furthermore this indirect method was compared with FAIRLEY'S direct method for localization of UTI in female patients with indwelling catheters. All tests were positive in patients with nephrostomies and acute pyelonephritis. Out of 19 tests in patients with chronic pyelonephritis, 18 were positive and one negative. Antibody-coated bacteria were present in 4 out of 8 patients with chronic cystitis and in 2 out of 9 patients with acute cystitis. Out of 5 male patients with dysuria and significant bacteriuria, 3 had a positive test. Out of 25 women with indwelling catheters 20 exhibited antibody-coated bacteria in urine and 5 did not. In 9 female patients with indwelling catheters the UTI was localized in the upper tract 5 times by the Fairley technique but 7 times by determination of antibody-coated bacteria. The demonstration of antibody-coated bacteria in the urine is a simple and reliable method of localizing the site of a UTI. False positive results may be observed in patients with indwelling catheters and prostatitis; in both instances there is probably local antibody production and coating of the bacteria. As the test is relatively expensive and time-consuming, it is indicated only in special situations and is not considered a routine screening procedure.
Aged↗
Urinary tract infections.
Urinary tract infections can be found in either sex at any age. While the majority occur in adult females as acute cystitis, recurrent symptomatic bacteriuria, or asymptomatic bacteriuria, adult males with prostatitis or acute pyelonephritis and children with symptomatic urinary tract infections comprise a considerable portion of patients seen. Management in pregnant females or in males with indwelling catheters or before prostatic surgery presents special problems. The choice of drug and dosage schedule should vary according to the infecting agent and the clinical state of the patient.
Anti-Infective Agents↗
Frequency of E. coli K antigens in urinary-tract infections in children.
The somatic (O) and casular (K) antigens of Escherichia coli from the urine of patients with acute pyelonephritis, acute cystitis, and asymptomatic bacteriuria, and in the faeces of healthy schoolchildren have been investigated. Typing antisera for sixteen capsular acidic polysaccharide K antigens were used, and five (numbers 1, 2, 3, 12, and 13) accounted for 70% of isolates from patients with acute pyelonephritis. These five K antigens were found to a lesser extent in the three other study groups. Thus, only a few K polysaccharides are associated with virulent properties of E. coli for the upper urinary tract. This finding is similar to the association of only some capsular types of pneumococci, meningococci, and Haemophilus influenzae with invasiveness. The identification of virulence markers for E. coli associated with upper-urinary-tract disease may permit more successful control with reference to preventive immunisation.
Acute Disease↗
Treatment of cefazolin in 45 cases of urinary tract infections.
We have treated 45 cases of urinary tract infection with cefazolin (i.m.) and cure was achieved in 35 (77.77%). 26 of the 28 patients (92.85%) with acute cystitis who received 250 mg every 12 h for 6-10 days were cured. 17 patients with pyelonephritis received 500 mg every 12 h during 10-14 days and therapeutical success was achieved in 9 of them (52.94%). Laboratory control was carried out at the initiation of therapy, at the end, and 1 month after therapy. Tolerance to injections of cefazolin was considered good and only in one case appeared a mild eosinophia.
Acute Disease↗
Autoantibodies to Tamm-Horsfall protein, a tool for diagnosing the level of urinary-tract infection.
In sera from ten girls with acute pyelonephritis, antibodies of the IgG-class to Tamm-Horsfall protein were found in significantly increased titres; in contrast, titres in sera from six girls with acute cystitis did not differ from those of healthy controls. The results suggest that determination of Tamm-Horsfall antibodies may prove useful for differentiating between upper and lower urinary-tract infection.
Acute Disease↗
Adhesiveness to urinary tract epithelial cells of fecal and urinary Escherichia coli isolates from patients with symptomatic urinary tract infections or asymptomatic bacteriuria of varying duration.
Adhesiveness to human urinary tract epithelial cells was high for Escherichia coli strains isolated from patients with acute pyelonephritis and acute cystitis, and low for asymptomatic bacteriuria strains detected at screening. Escherichia coli bacteria causing asymptomatic reinfections, detected near the onset of bacteriuria, adhered more than those detected at screening. No difference in the adhesive ability was found between fecal isolates of the strain causing urinary tract infection, isolated at or before onset of bacteriuria, and the urinary strain in symptomatic or asymptomatic patients. Normal fecal Escherichia coli from non-bacteriuric patients adhered less than all other strains tested.
Adhesiveness↗