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1/6. Acute renal failure in adults with uncomplicated acute pyelonephritis: case reports and review.

    Acute renal failure is a rare complication of acute pyelonephritis in patients who do not have urinary obstruction. Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure nor is renal failure considered a likely consequence of bacteriuria. In this review, the cases of acute renal failure caused by acute pyelonephritis that have been reported in the last quarter century are examined. Including two new cases reported, only 12 cases of acute pyelonephritis resulting in acute renal failure were found. Three of these occurred in patients with a solitary kidney. All cases occurred in individuals who had no history of urinary tract infections, and all were caused by Escherichia coli. In several cases, the administration of non-steroidal antiinflammatory drugs contributed to disease. Three cases occurred after catheter-acquired bacteriuria. Acute renal failure is an uncommon but serious consequence of uncomplicated acute pyelonephritis in adults.
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ranking = 1
keywords = bacteriuria
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2/6. Success of dna fingerprinting after failure of biotyping, antimicrobial susceptibility testing, and plasmid analysis to reveal clonality of multiple blood and urine isolates from a patient with Escherichia coli urosepsis.

    Multiple isolates of Escherichia coli from the blood and urine of a 60-year-old woman with acute pyelonephritis exhibited different biotypes, antimicrobial susceptibility patterns, and plasmid profiles, suggesting the presence of polymicrobial bacteriuria and leaving in question the origin of the bacteremia. Only after bacterial restriction endonuclease analysis of total bacterial DNA was it discovered that all isolates represented the same strain, with plasmid instability possibly accounting for the varied antimicrobial susceptibility patterns observed. We conclude that the biotype, antimicrobial susceptibility profile, and plasmid profile are sometimes inadequate to clarify the relationships between different clinical isolates of E. coli from a single patient and can lead to erroneous epidemiologic conclusions. dna fingerprinting can resolve dilemmas these less precise techniques leave unresolved.
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ranking = 0.5
keywords = bacteriuria
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3/6. epididymitis as cause of antibody-coated bacteria in urine.

    The antibody-coated bacteria (ACB) immunofluorescence test has emerged as the preferred noninvasive technique to distinguish reliably between pyelonephritis and cystitis. Investigators have recently correlated a positive test with chronic bacterial prostatitis and cystitis complicating a bladder tumor or stone. We present data that appear to prove that acute bacterial epididymitis associated with bacteriuria can also evoke a positive ACB determination.
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ranking = 0.5
keywords = bacteriuria
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4/6. Xanthogranulomatous pyelonephritis in renal transplant recipient.

    Xanthogranulomatous pyelonephritis is reported in the native kidney of a renal allograft recipient. Immunoglobulin deposition in the transplant kidney in the absence of cell-mediated rejection, accompanied by selective cultures showing Escherichia coli from the native kidney, led to the diagnosis. Native nephrectomy resulted in resolution of the patient's chronic bacteriuria and creatinine elevation.
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ranking = 0.5
keywords = bacteriuria
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5/6. cerebrospinal fluid shunt infection secondary to Escherichia coli bacteriuria.

    A 10-year-old girl with a lumbosacral myelomeningocele, managed with clean intermittent catheterization, presented with headache, vomiting, and lethargy. The cerebrospinal fluid (CSF) and urine cultures revealed Escherichia coli, documented to be the same subtype. The organisms were subtyped and the E. coli from both the urine and CSF were noted to be of the same strain. Management consisted of intravenous antibiotics and ultimate replacement of the ventriculoperitoneal shunt. Children with myelodysplasia and CSF shunts should be carefully monitored in a multidisciplinary fashion to anticipate, correctly diagnose, and treat CSF shunt infections associated with bacteriuria.
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ranking = 2.5
keywords = bacteriuria
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6/6. Persistent bacteriuria caused by uropathogenic escherichia coli.

    The predominant strain of Escherichia coli, the most frequently associated causative agent of urinary tract infections (UTI), in the rectal flora of patients with UTI has been reported to match the strain associated with the etiologic agent of UTI. Since acquisition of UTI may depend on the immediate surrounding flora of the patient, the chromosomal DNAs of strains of E. coli isolated from 3 patients suffering from recurrent cystitis and asymptomatic bacteriuria were examined by multiple polymerase chain reaction using 6 sets of primers for all the known urovirulence factors and by pulsed-filed gel electrophoresis. Genetically identical or similar strains were continuously isolated from these patients and each strain carried the identical urovirulence factors. The findings strongly supported the previous notion that the acquisition of UTI is dependent upon the occurrence of the strain carrying the urovirulence factors in patients or in the environment.
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ranking = 2.5
keywords = bacteriuria
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