Antibody-Coated Bacteria in the Urine and the Site of Urinary-Tract Infection

Thomas, Virginia L.; Shelokov, Alexis; Forland, Marvin

doi:10.1056/nejm197403142901102

Cited by 323 publications

(104 citation statements)

References 8 publications

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“…Peripheral blood was obtained from nine patients (seven males, two females) with an established diagnosis of CF (mean age 20 yr, range [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], and from one patient with intrinsic asthma and chronic bronchitis (COLD). These subjects were clinically stable but had experienced numerous respiratory infections with P. aeruginosa, and their sputum remained colonized with Pseudomonas organisms.…”

Section: Methodsmentioning

confidence: 99%

Cystic fibrosis pseudomonas opsonins. Inhibitory nature in an in vitro phagocytic assay.

et al. 1981

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A B S T R A C T Pseudomonas aeruginosa infection plays a primary pathogenetic role in the chronic respiratory tract disease of cystic fibrosis (CF) patients. Despite pronounced humoral immune responses, reflected by high levels of antibodies against Pseudomonas in serum and in sputum, the antibodies do not eliminate this bacterium. In the present study we have used affinity chromatography with a lipopolysaccharide substituted immunoadsorbent gel to isolate high titers (meanCF = 1:256) of immunotype specific Pseudomonas IgG antibodies from the sera of nine CF subjects, and have evaluated the functional ability of these antibodies to promote phagocytosis and intracellular killing of P. aeruginosa in an in vitro human alveolar macrophage culture system.The phagocytic and intracellular bactericidal kinetics revealed that CF IgG antibodies function in an inhibitory fashion. Both the rate of phagocytosis (rateCF = 204 cpm/unit time) and absolute bacterial uptakes maximal at 120 min (uptakecF = The cellular and humoral immune systems in subjects with CF appear to function normally (1, 3-5) with one major exception: whole serum appears to interfere with the phagocytic function of alveolar macrophages (AM). Whole serum from homozygous CF patients inhibits the ability of rabbit and human AM to ingest and destroy Pseudomonas bacteria (6-9). This effect has been variously attributed to a serum deficiency, to a heat-labile factor, or more recently, to a heat-stable inhibitory factor in CF sera (6-9). "Bactericidal blocking" antibodies have been suggested as an explanation for the selective inability of CF whole serum to support Pseudomonas bactericidal activity (10).Optimal phagocytosis of Pseudomonas by polymorphonuclear leukocytes (PMN) or AM requires the presence of heat-stable opsonins (11,12), and of the heat-stable opsonins IgG has superior protective activity when compared with secretory IgA or . Murphy et al. (15) have studied the role of complement in the phagocytosis of Pseudomonas by rabbit AM. These authors concluded that specific antibody is required for efficient phagocytosis but that in the presence of an excess amount of antibody (as in CF) complement was not essential to maximize phagocytosis. Similarly, IgG antibodies in convalescent sera have been shown to augment phagocytosis of Pseudomonas even in the absence ofheat-labile (complement) opsonins (16,17). Because of the importance of immune IgG in the phagocytic process, and special constraints in antibody binding to macrophages imposed by specific cell surface receptors (18), it is likely that such an opsonic antibody deficiency would be in the IgG class.While CF patients have a generous antibody response in serum, sputum, and to a lesser degree, in lung lavage fluid to P. aeruginosa somatic antigens, the functional capacity of these specifically purified antibodies has not been studied directly. To investigate the opsonic, phagocytic, and bactericidal properties of P. aeruginosa lipopolysaccharide type-specific IgG opsonins (Pseudomonas antibodies), w...

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Section: Methodsmentioning

confidence: 99%

Cystic fibrosis pseudomonas opsonins. Inhibitory nature in an in vitro phagocytic assay.

et al. 1981

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“…The presence of antibody-coated bacteria in the urine has been considered diagnostic for upper urinary tract infections since the work of Thomas, Shelokov & Forland (1974) and Jones, Smith & Sanford (1974). Some recent studies have failed to verify the accuracy of this test (Barnet & Abbot, 1978;Hellerstein et al 1978;Forsum et al 1978;Rumans & Vosti, 1978) but Fang, Tolkoff-Rubin & Rubin (1978) have used it as a basis for treatment.…”

Section: Introductionmentioning

confidence: 99%

Correlation between uropathogenic properties ofEscherichia colifrom urinary tract infections and the antibody-coated bacteria test and comparison with faecal strains

Brooks

Benseman

Peck

et al. 1981

J. Hyg.

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SUMMARYStrains of Escherichia coli isolated from adult females with symptomatic urinary tract infection were found to possess the following properties significantly more frequently than faecal strains: (i) high K-antigen titre; (ii) haemolysin; (iii) type 1 pili; (iv) mannose-resistant haemagglutination; (v) fermentation of dulcitol and salicin; (vi) 0 serotype 2, 6 and 75; (vii) H serotype 1. E. coli isolated from urine specimens containing significant numbers of antibody-coated bacteria were richer in these seven properties than strains from urines without detectable antibodycoated bacteria.The 0 and H serotypes of E. coli obtained from patients with urinary tract infection in two New Zealand cities were compared with those reported in the world literature and found to be similar.

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“…The purposes of this study were: (i) to determine the efficacy and safety of the combination of amoxicillin and potassium clavulanate in the treatment of urinary tract infections; (ii) to attempt to relate therapeutic responses to the results of antibody-coated bacteria tests (25); and (iii) to assess the changes in the carrier state of the resistant urinary pathogens in the rectal, vaginal, and periurethral sites.…”

mentioning

confidence: 99%

Treatment of urinary tract infections with a combination of amoxicillin and clavulanic acid

Iravani¹,

Richard²

1982

Antimicrob Agents Chemother

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A 10-day course of amoxicillin (250 mg)-potassium clavulanate (125 mg) was administered three times daily to 116 female college students with urinary tract infections. All of the bacterial isolates from these patients were susceptible to amoxicillin-potassium clavulanate in vitro; only 81.0%0 were susceptible to amoxicillin alone. Evaluations at 1 week after completion of this course showed that clinical and bacteriological cures had been achieved in 96.9%0 of those who completed therapy. Cures were sustained in 85.6% of the patients examined at 4 weeks after the end of therapy. Therapeutic responses were comparable, irrespective of the results of antibody-coated bacteria tests. All strains of Enterobacteriaceae isolated from the rectal and urogenital sites at 1 week after therapy were susceptible to amoxicillin-potassium clavulanate. The proportion of fecal Escherichia coli resistant to amoxicillin alone increased from 13.3% before therapy to 35.6% at 1 week after therapy. Adverse drug reactions consisted of gastrointestinal symptoms (9.8%) and rashes (4.1%). Sixteen patients (14.2%) developed symptomatic candida vaginitis by 1 week after therapy.Ampicillin and its analog amoxicillin have been extensively used for the treatment of urinary tract infections (5, 6). The widespread use of these P-lactam antibiotics has been associated with the emergence of resistant strains of various pathogens, resulting in an increased number of therapeutic failures (12, 17, 22). Resistance to these agents is usually mediated by the production of P-lactamases which inactivate these antibiotics (1). Clavulanic acid, a naturally occurring 3-lactamase inhibitor, may prevent the inactivation of these P-lactams (8,21). Combinations of clavulanic acid and amoxicillin are significantly more active both in vitro and in vivo against certain ,B-lactamase-producing bacteria than is amoxicillin alone (11,18).The purposes of this study were: (i) to determine the efficacy and safety of the combination of amoxicillin and potassium clavulanate in the treatment of urinary tract infections; (ii) to attempt to relate therapeutic responses to the results of antibody-coated bacteria tests (25)

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Antibody-Coated Bacteria in the Urine and the Site of Urinary-Tract Infection

Cited by 323 publications

References 8 publications

Cystic fibrosis pseudomonas opsonins. Inhibitory nature in an in vitro phagocytic assay.

Cystic fibrosis pseudomonas opsonins. Inhibitory nature in an in vitro phagocytic assay.

Correlation between uropathogenic properties ofEscherichia colifrom urinary tract infections and the antibody-coated bacteria test and comparison with faecal strains

Treatment of urinary tract infections with a combination of amoxicillin and clavulanic acid

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