Studies of Urinary Tract Infections in Infancy and Childhood

Abstract

Haemagglutination tests for study of the antibody response t o the infecting coli organisms in urinary tract infections in adults were first published in 1955 by Needell, Neter, Staubitz & Bingham [16]. They used bacteria, isolated from the actual patient's urine as a source of antigen and found a significant rise of the antibody titres in 50 yo of their patients. In a recent publication [25] we were able to demonstrate similar findings in infants and children. Our findings also suggested a difference in the antibody response between patients with pyelonephritis and with cystitis. This could mean that determination of the amount of antibodies present in the serum might be a valuable help in separating cases of urinary tract infections in categories with regard to the degree of tissue invasion and, possibly, the localization of the infection.The present study is especially concerned with the course of the serum antibody titre in patients with acute urinary tract infections caused by E. coli. It was performed in order to obtain a more com-plete basis for evaluation of work now in progress on different problems of the bacteriology, immunology and management of urinary tract infections. MaterialThe stridy included 55 patients and there were 80 controls. Diagnosis and clwssification. All patients had acute symptoms. The febrile patients exhibited several clinical signs of pyelonephritis such as irritability, paleness, vomiting, abdominal or loin pains and tenderness, while the non-febrilc patients lacked these symptoms, only showing dysuria, pollacisuria and/or dribbling, suggestive of lower urinary tract infection.The diagnosis of urinary tract infection was based on the above-mentioned clinical symptoms and the following laboratory evidence :

Die Bakteriurie aus der Sicht des Bakteriologen

“…Die Ansicht, daß nur konstant nachweisbare Erreger mit konstantem Antibiogramm ais pathogen angesehen werden können (17), kann nicht ohne Einspruch hingenommen werden. Untersuchungen von Grönroos und Mitarbeitern (15) ergaben, daß bei einigen E.-coii-Infektionen zwei oder mehr Serotypen auftreten können. Noch überzeugender in dieser Hinsicht sind Ergebnisse von Petersen und Mössner (38): Sie fanden unter 21 Harnwegsinfektionen durch E. coli 14 Fälle mit zwei oder drei Serotypen.…”

“…Knothe (25) konnte in einigen Urinen zwei oder drei Enterokokken-Serotypen feststellen. Uber einen Erregerwechsel vorwiegend bei Rezidiven oder unter der Therapie berichteten Grönroos und Mitarbeiter (15) sowie Baumann und Gruhn (5).…”