Localization and Fate of Escherichia Coli in Hematogenous Pyelonephritis

Abstract

1. Hematogenous E. coli pyelonephritis was produced in rats. The localization of the organisms and the persistence of bacterial antigens was followed by fluorescent antibody techniques as well as by standard histological and bacteriological methods. 2. Salient sequential features were as follows: Single organisms passed through vessel walls into the renal interstitium and began multiplication and subsequently evoked a leucocytic response. Bacterial multiplication did not occur in glomeruli or renal tubular cells. Bacteria did not appear within renal tubular lumina until microabscesses were well developed in the renal interstitium. Bacteriuria appeared late and represented secondary invasion rather than filtration of organisms. The infection healed spontaneously but, while sterile, the parenchymal scars contained large amounts of residual bacterial antigen. The persistence of bacterial antigen did not result in continuing inflammatory changes or progressive scarring. 3. The persistence of bacterial antigens is postulated to constitute a major antigenic stimulus responsible for active immunity in experimental hematogenous pyelonephritis.

Prevention of chronic experimental pyelonephritis by suppression of acute suppuration.

“…The persistence ofbacterial antigens in the late phase of pyelonephritis has been shown both in experimental and human kidney infections (25,26,5). It has been suggested therefore that this could lead to the progression of the disease by a process involving antigenantibody complexes (5,9).…”

The local immune response to Escherichia coli O and K antigen in experimental pyelonephritis.

“…a vigorous host immune response once infection is established (1, 4). It has not been established whether K antigen persists as 0 antigen does (7,8). Hence, it is not known if K antigen contributes to the persistence of organisms in the kidney as has been postulated for 0 antigen (1).…”

“…Clinical studies have shown that serum antibody to 0 antigen can be of diagnostic value in patients with pyelonephritis, whereas patients with bladder infection do not develop a serum antibody response (1,5,6). Furthermore, 0 antigen has been shown to persist in the kidney beyond the stage when viable bacteria can be cultured (7,8); however, its significance in the pathogenesis of progressive renal destruction is unclear.…”

A Search for Escherichia coli Antigens in Kidneys from Children with Urinary Tract Infection by Means of Immunofluorescence

“…In animal experiments, however, antigen has been shown for several months after infection (3,7,8,20,28), and in most of our patients there were only a few months between the last infection period and the operation. Furthermore, Aoki et al (2) found residual bacterial antigen in kidneys from adults known t o have been free of signs of infection for some years.…”

“…(3), Cotran et al (8), and Sanford scarring of the renal tissue. et al (28) in animals with experimental pyelonephritis as well as by Aoki et al (2) and Schwartz et al (29) in adult humans CASE REPORT using immunofluorescence technique and it has been suggested that this could be responsible for the slowly developing renal…”