Antibody-coated Bacteria In Urine Research Articles

Antibody-coated bacteria in urine: when, where and why?

Antibody-coated bacteria in urine: when, where and why?

Single-dose amoxicillin therapy with follow-up urine culture: Effective initial management for acute uncomplicated urinary tract infections

To learn whether a single dose of amoxicillin is safe, effective therapy for acute uncomplicated urinary tract infections, 388 symptomatic nonpregnant women were randomly grouped to receive oral amoxicillin, either as a single 3 g dose or 250 mg three times a day for two weeks. Patients had quantitative as well as dip-slide cultures of urine and tests for antibody-coated bacteria in urine. Follow-up urine cultures were obtained one week after completion of treatment. Results of antimicrobial susceptibility and antibody-coated bacterial tests did not alter the randomized therapy. Among 162 patients with bacteriologically confirmed infections, cure rates were 60.6 percent (43 of 71) for single-dose versus 73.6 percent (67 of 91) for two-week treatment (p = 0.07). Although more antibody-coated bacteria-negative patients (89.6 percent; 26 of 29) were cured overall, a substantial proportion of antibody-coated bacteria-positive patients were also cured by both single-dose (59.3 percent; 32 of 54) and 14-day therapy (64.6 percent; 42 of 65). There were fewer adverse effects in the single-dose treatment group. We conclude that a single 3 g dose of amoxicillin, with follow-up urine culture, provides safe and effective management for acute uncomplicated urinary tract infections in nonpregnant women.

Antibody-Coated Bacteria in Urinary Tract infections

In 1974 we reported that a non-invasive fluorescent antibody (FA) test is useful in establishing the anatomic site of infection in the urinary tract [1]. The technique utilizes a simple and direct immunofluorescence procedure to detect antibody-coated bacteria (ACB) in urine sediments of patients with urinary tract infections. ACB are usually found in urine samples from patients with kidney infections but not from patients with uncomplicated bladder infections. This review focuses on the efforts of our own laboratory and the work of other investigators in (1) evaluating the clinical application of the test for ACB as a diagnostic aid, (2) determining the usefulness of the test in defining populations for epidemiologic and therapeutic studies, (3) ascertaining the prognostic usefulness of the test in following the clinical course of the individual patient with persistent or recurrent infections, and (4) defining the biological significance of ACB in urine.

Antibody-coated bacteria in urinary tract infections

In 1974 we reported that a non-invasive fluorescent antibody (FA) test is useful in establishing the anatomic site of infection in the urinary tract [1]. The technique utilizes a simple and direct immunofluorescence procedure to detect antibody-coated bacteria (ACB) in urine sediments of patients with urinary tract infections. ACB are usually found in urine samples from patients with kidney infections but not from patients with uncomplicated bladder infections. This review focuses on the efforts of our own laboratory and the work of other investigators in (1) evaluating the clinical application of the test for ACB as a diagnostic aid, (2) determining the usefulness of the test in defining populations for epidemiologic and therapeutic studies, (3) ascertaining the prognostic usefulness of the test in following the clinical course of the individual patient with persistent or recurrent infections, and (4) defining the biological significance of ACB in urine.

Antibody-coating of bacteria in the urine in relation to various immunologic indexes

Little is known about the immunologic aspects of antibody coating, though the test for determining antibody-coated bacteria in urine has been examined for its diagnostic uses by many authors after its inauguration in 1974. In adults with chronic pyelonephritis with and without antibody-coated bacteria in the urine, we tested whether bacterial coating is correlated with the homologous O-antibody titre in the urine. We also determined Ig levels in urine and serum, as well as homologous O-antibody titres in serum. By means of indirect immunofluorescence technique, we were able to show homologous O-antibodies in the urine of all patients with and without antibody-coated bacteria. IgG and IgA levels in urine were mostly raised, as were often the O-antibody titres in the serum. There were no significant differences in the immunologic parameters within the patient groups with or without antibody-coating. The presence of homologous O-antibodies in urine does not therefore necessarily lead to coating of the bacteria.

Detection of antibody-coated bacteria in children with urinary tract infections

The demonstration of antibody-coated bacteria in urine is a valuable supplementary test for localizing urinary tract infections. When interpreting the results the age of a child, however, is also an important factor. In babies, acute pyelonephritis is often not accompanied by antibody-coated bacteria in the urinary sediment. In chronic pyelonephritis an important factor is the stage of the disease since no antibody-coated bacteria have been detected with bacteriuria in the latent phase. Urine to be tested for the presence of antibody-coated bacteria must be collected in a sterile fashion. No diagnostic value can be attached to a positive result unless this prerequisite has been met.

Diagnostic value and biological significance of antibody-coated bacteria in urine.

The incidence of antibody-coated bacteria (ACB) in the urinary sediments as an indication of the site of urinary tract infections (UTI) was investigated in 103 adult subjects with persistent bacteriuria by means of a direct immunofluorescence technique.ACB were found in 49 of 58 (84.5%) subjects with long-standing upper urinary tract obstruction and in 5 of 45 (11.1%) with lower UTI; this difference was statistically significant (X(2) = 51.79; P<0.001). The group with upper UTI was further subdivided according to renal function (patients with renal insufficiency had both bilateral obstruction and bilateral renal damage); 21 positive results were obtained in 27 (77.8%) patients with normal renal function, whereas 28 positive cases were observed among 31 (90.3%) patients with chronic renal insufficiency. Thus the degree of renal involvement also seemed to influence the outcome of the test. Within the group of lower UTI, a higher rate of ;false-positive' results was obtained in 14 patients with symptomatic long-standing infection (21.4%) than in 31 subjects with asymptomatic bacteriuria (6.4%). The three major immunoglobulin classes and the secretory component were studied in 42 cases. Of these, 29 were found to be positive for ACB. The constant presence of IgA and secretory component on the surface of ACB suggests that the secretory immune system plays an important role in UTI.

Epididymitis as cause of antibody-coated bacteria in urine

The antibody-coated bacteria (ACB) immunofluorescence test has emerged as the preferred noninvasive technique to distinguish reliably between pyelonephritis and cystitis. Investigators have recently correlated a positive test with chronic bacterial prostatitis and cystitis complicating a bladder tumor or stone. We present data that appear to prove that acute bacterial epididymitis associated with bacteriuria can also evoke a positive ACB determination.

Antibody-coated bacteria in the urine of infants and children with their first two urinary tract infections.

The presence of antibody-coated bacteria in urine has been shown to be an indicator for renal bacteriuria in adults with chronic UTI. To evaluate this method (ABCU test) in pediatric patients, 128 infants and children with their first UTI were investigated. Twenty-nine patients of the 78 who had a first clinically defined upper UTI had antibody-coated bacteria in urine. The test was seldom (2/20) positive in the infants under six months. In the older patients (27/58 ABCU-positive) the frequency of positive tests increased with the duration of symptoms. When the symptoms had lasted for over one weeks, 11 out of the 13 children with their first upper UTI showed antibody-coated bacteria in urine. Four of the 36 first lower UTIs and 5 out of the 14 asymptomatic cases were ABCU-positive. The patients were followed-up for an average of 9 months. Those who were classified as having first upper UTI had in most cases a positive ABCU test in recurrences, independently of the clinical picture. The recurrences after the first lower UTIs showed antibody-coated bacteria in urine only when the recurrence was classified as upper UTI on the grounds of the clinical criteria used.

Antibody-coated bacteria in urine of patients with ileal conduit urinary diversion

The antibody-coated bacteria (ACB) test is a helpful adjunct for differentiating pyelonephritis from cystitis in the intact urinary tract, particularly in female patients. This test was used in patients with ileal conduits and infected urine in an attempt to determine whether bacilluria was of renal or conduit origin. Every patient with infected conduit urine had a positive ACB test even though no patient had clinical stigmas of acute pyelonephritis. In patients with ileal conduits, the ACB test cannot be used alone as an indicator that bacilluria is a cause of symptoms or renal damage.

The prevalence of antibody-coated bacteria in urine.

The prevalence of urinary antibody-coated bacteria (ACB), suggesting renal bacteriuria, was studied in three groups of patients: inpatients whose physicians suspected urinary tract infections, asymptomatic outpatients with neurogenic bladders but without urethral catheters, and asymptomatic inpatients with indwelling urethral catheters. The prevalence of ACB was 67% of inpatients with positive cultures without catheters, 94% of patients with neurogenic bladders, and 36% of patients with urethral catheters. These results suggest a high prevalence of upper urinary tract involvement in patients with positive urine cultures, even if asymptomatic.

Antibody-Coated Bacteria in Urine

Antibody-Coated Bacteria in Urine

Antibody-coated bacteria in the urine of children with urinary tract infections.

The test for antibody-coated bacteria in urine for the diagnosis of the anatomical level of urinary tract infections was evaluated in children with UTI. The ability of the test to differentiate between an upper and lower infection is influenced by the antiglobulin preparation used, since too sensitive an antiglobulin probably detects nonspecifically bound antibodies. Staphylococcal protein A seems to be well suited for use as an antiglobulin in this test. Using staphylococcal protein A all children with X-ray findings suggesting renal damage had antibody-coated bacteria in the urine, however, nine infants and 5 children and clinical symptoms of pyelonephritis had a negative test. Of 28 children with clinical symptoms of cystitis only one had a positive test. Of 50 children with asymptomatic bacteriuria 9 had antibody-coated bacteria in the urine; 41 had not. The findings indicate that the method might be useful in establishing the anatomical level of urinary tract infection and might also be useful for screening children with asymptomatic bacteriuria who risk developing kidney infections.

Letter: Prostatitis as cause of antibody-coated bacteria in urine.

Letter: Prostatitis as cause of antibody-coated bacteria in urine.