Urovirulence determinants in Escherichia coli isolates causing first-episode and recurrent cystitis in women

Article Abstract:

Strains of the bacteria Escherichia coli (E. coli) associated with acute, uncomplicated pyelonephritis and urinary tract infections possess specific virulence determinants such as hemolysis, or the ability to destroy red blood cells. (Pyelonephritis refers to inflammation of the kidney and pelvis. Virulence determinants affect the pathogenesis and severity of infections.) The majority of urinary tract infections (UTIs) in women are usually uncomplicated cystitis (bladder infections), but little data is available on the prevalence of virulence determinants in these cases. Three groups of age-matched, nonpregnant women were assessed: 54 with their first episode of cystitis; 33 with recurrent cystitis; and 52 with no UTI history (control group). Midstream urine specimens were obtained from the infected cases (87 women), and fecal swabs were obtained from the control group (52 women). All specimens were cultured for E. coli bacteria. First-episode and recurrent cystitis cases provided 121 isolates of E. coli, and the control group yielded 156 fecal isolates of E. coli. The presence of several virulence determinants (P fimbriae, hemolysis, aerobactin, and diffuse adhesin) was identified using DNA probes. The results are presented in detail. The findings suggest that the use of diaphragms altered the presence and concentration of E. coli virulence determinants. Hence, women who use diaphragms may develop UTIs with less virulent strains of E. coli. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Development and progression, Escherichia coli, Identification and classification, Urinary tract infections, Cystitis

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Trimethoprim-sulfamethoxazole prophylaxis in the management of chronic granulomatous disease

Article Abstract:

Chronic granulomatous disease (CGD) is a rare disorder that impairs the function of leukocytes (white blood cells). The disease can be X-linked (carried on the X chromosome) or it can be autosomal (carried on a chromosome other than the X chromosome). Trimethoprim-sulfamethoxazole (TMP-SMX) is an antibiotic that is commonly used in the prophylactic (preventive) treatment of CGD. In previous studies, the use of TMP-SMX in cancer patients resulted in an increased incidence of fungal infections. Therefore, the prevalence of fungal infections in CGD patients treated with TMP-SMX was evaluated. The medical records of patients admitted to the National Institute of Health, between January of 1970 and December of 1988, were examined to identify all cases of CGD. A total of 43 patients with CGD were identified. Prophylactic treatment with TMP-SMX reduced the incidence of nonfungal infections from 7.1 to 2.4 cases and from 15.8 to 6.9 cases per 100 patient-months in patients with autosomal and X-linked CGD, respectively. TMP-SMX did not alter the incidence of fungal infections in patients with CGD. These results indicate that TMP-SMX reduces the incidence of nonfungal infections in patients with CGD, but does not increase the incidence of fungal infections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Prevention, Co-trimoxazole, Trimethoprim-sulfamethoxazole (Drug combination), Chronic granulomatous disease

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