TY - JOUR
T1 - Antibody-coated bacteria as an indicator of the site of urinary tract infection in renal transplant recipients receiving immunosuppressive agents
AU - Keren, David F.
AU - Nightingale, Stephen D.
AU - Hamilton, Cheryl L.
AU - Charache, Patricia
AU - Walker, W. Gordon
PY - 1977/12
Y1 - 1977/12
N2 - Distinguishing an infection in the upper urinary tract from one in the lower urinary tract is especially important in renal transplant patients. Although the presence of antibody-coated bacteria in the urine has been shown by others to be a reliable indication of an infection in the upper urinary tract, it was not known whether sufficient antibody to coat the bacteria would be produced in a renal transplant recipient undergoing immunosuppression. We used a fluorescent test for detecting antibody-coated bacteria in the urine to follow 80 renal transplant patients prospectively for six months. Antibody-coated bacteria were detected in specimens from four patients with a clinical picture compatible with, or histopathologic evidence of, pyelonephritis. The origin of bacteriuria in a fifth patient was indeterminate both clinically and by the fluorescent antibody test. Twenty-three other patients with bacteriuria without clinical or histopathologic evidence of pyelonephritis had negative tests for antibody-coated bacteria. One patient with pyelonephritis in her own end-stage kidney had persistent bacteriuria with a negative fluorescent antibody test. Her transplanted kidney, however, was not infected. A positive test for antibody-coated bacteria is judged useful in distinguishing an infection in the upper urinary tract from one in the lower urinary tract in the presence of immunosuppression; however, the small number of cases and the methods used do not allow us to draw a conclusion about the significance of a negative result in a population undergoing immunosuppression.
AB - Distinguishing an infection in the upper urinary tract from one in the lower urinary tract is especially important in renal transplant patients. Although the presence of antibody-coated bacteria in the urine has been shown by others to be a reliable indication of an infection in the upper urinary tract, it was not known whether sufficient antibody to coat the bacteria would be produced in a renal transplant recipient undergoing immunosuppression. We used a fluorescent test for detecting antibody-coated bacteria in the urine to follow 80 renal transplant patients prospectively for six months. Antibody-coated bacteria were detected in specimens from four patients with a clinical picture compatible with, or histopathologic evidence of, pyelonephritis. The origin of bacteriuria in a fifth patient was indeterminate both clinically and by the fluorescent antibody test. Twenty-three other patients with bacteriuria without clinical or histopathologic evidence of pyelonephritis had negative tests for antibody-coated bacteria. One patient with pyelonephritis in her own end-stage kidney had persistent bacteriuria with a negative fluorescent antibody test. Her transplanted kidney, however, was not infected. A positive test for antibody-coated bacteria is judged useful in distinguishing an infection in the upper urinary tract from one in the lower urinary tract in the presence of immunosuppression; however, the small number of cases and the methods used do not allow us to draw a conclusion about the significance of a negative result in a population undergoing immunosuppression.
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U2 - 10.1016/0002-9343(77)90536-8
DO - 10.1016/0002-9343(77)90536-8
M3 - Article
C2 - 343586
AN - SCOPUS:0017761304
SN - 0002-9343
VL - 63
SP - 855
EP - 858
JO - The American journal of medicine
JF - The American journal of medicine
IS - 6
ER -