Anti-Bacterial Agents/therapeutic use* ; Child ; Humans ; Microbial Sensitivity Tests ; Urinary Tract Infections/drug therapy*

To study the mechanism of polysaccharides from seeds of Vaccaria segetalis( PSV) in the treatment of bacterial cystitis through the NLRP3 inflammasome pathway. The rat model of urinary tract infection was used and treated with PSV,and the urine and bladders were collected. The level of interleukin-10( IL-10) in rat urine was detected by enzyme linked immunosorbent assay( ELISA). Western blot and immunofluorescence staining were used to detect the expressions of sonic hedgehog( SHH) and NLRP3 inflammasome [NOD-like receptor thermoprotein domain 3( NLRP3),apoptosis associated speck like protein( ASC) and pro-caspase-1]. The expression of Toll-like receptor pathway was detected by RT-PCR. The death of 5637 cells induced by uropathogenic Escherichia coli( UPEC) and lactate dehydrogenase( LDH) release were evaluated using live/dead staining. The results showed that in the rat bladder,the expressions of SHH,NLRP3 inflammasomes and Toll-like receptors were significantly up-regulated,and NLRP3 inflammasomes were significantly activated by UPEC infection. The administration with PSV could significantly increase the concentration of IL-10 in urine,inhibit the expressions of SHH,NLRP3 inflammasomes and Toll-like receptors in bladder,and inhibit the activation of NLRP3 inflammasomes. A large number of 5637 cells were dead after UPEC infection and caused LDH production. PSV could significantly inhibit the death of 5637 cells and the release of LDH. In conclusion,PSV could inhibit the expression and activation of NLRP3 inflammasomes by inhibiting the Toll-like receptor pathway,thereby mitigating the bladder injury.
Animals ; Hedgehog Proteins ; Inflammasomes/genetics* ; Interleukin-1beta ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Polysaccharides/pharmacology* ; Rats ; Seeds ; Urinary Bladder ; Urinary Tract Infections/drug therapy* ; Vaccaria

As the famous Chinese patent medicine, Yinhua Miyanling Tablets, which was derived from ancient prescription denominated Bazhengsan, has not only the effects in clearing away heat and purging pathogenic fire, removing dampness and relieving stranguria, but also have the functions of detoxifying and tonifying. A great number of scientific studies have demonstrated that Yinhua Mi-yanling Tablets played significant roles in destroying harmful microbes and resisting inflammatory and diuresis. Compared with antibiotics, traditional antibacterial Chinese patent medicine Yinhua Miyanling Tablets has the advantage in bacterial resistance in long-term use. Fundamental studies about the content of pharmaceutical ingredients and the modern pharmacology of Yinhua Miyanling Tablets were collected and summarized, which conduces to indicating the active ingredients of Yinhua Miyanling Tablets with the medicinal efficacy from the molecular level and the internal mechanism of Yinhua Miyanling Tablets in the treatment of urinary tract infection(UTI) from the scientific perspective. In the field of clinical research, literatures associated with Yinhua Miyanling Tablets for the treatment of UTI were summarized and analyzed in terms of treatment type, administration mode, dosage, frequency of medication, course, efficiency, side effects and whether combined with healthy lifestyle. These literatures confirmed the medicinal values and the application prospect of Yinhua Miyanling Tablets in treating UTI, especially acute UTI, which provides a scientific theoretical foundation and a correct direction for the clinical application of Yinhua Miyanling Tablets. In conclusion, this article contributes to the standardization of Yinhua Miyanling Tablets in the treatment of UTI, in the expectation of giving the scientific guidance for clinical practice.
Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Research ; Tablets ; Urinary Tract Infections ; drug therapy

OBJECTIVE: To evaluate Chinese medicine (CM) formula Bazheng Powder () as an alternative therapeutic option for female patients with recurrent urinary tract infection (RUTI). METHODS: A randomized double-blinded trial was performed. Eligible female patients with RUTI were recruited from one hospital and two community health centers. By using a blocked randomization scheme, participants were randomized to receive a CM formula (10 herbs) for 4 weeks or antibiotics for 1 week, followed by 3 weeks of placebo. Clinical cure rate and microbiological cure and recurrence after treatment were evaluated. RESULTS: A total 122 eligible patients were enrolled, with 61 cases in each group. The clinical cure rate by the intentto- treatment approach was 90.2% for the CM group and 82.0% for the antibiotics group (P>0.05). Bacteria were cleared from 88.5% (54/61) of patients in the CM group and 82.0% (50/61) in the antibiotics group. The recurrence rate in recovered patients at the 6-month follow-up was 9.1% (5/61) and 14.0 (7/61) in the CM and antibiotics groups, respectively (P>0.05). CONCLUSION CM formula Bazheng Powder is a good alternative option for RUTI treatment. (Registration No. NCT01745328).
Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Double-Blind Method ; Female ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Recurrence ; Urinary Tract Infections ; drug therapy

Ningmitai Capsule is a classical patent medicine prepared from multiple effective ingredients of Chinese herbal medicine, with a wide range of biological activities and a significant efficacy in the treatment of urogenital diseases. Ningmitai Capsule has been widely applied in the management of urological and andrological diseases, with a particularly ideal effect on chronic prostatitis, since its first introduction nearly 20 years ago. With no obvious adverse effect on the male reproductive system, it has also been gaining a gradual application in the treatment of such diseases as urinary tract infections, diabetes, non-gonococcal urethritis, seminal vesiculitis, acute epididymitis, overactive bladder, hematuria, and semen non-liquefaction. However, the definite efficacy of Ningmitai Capsule needs to be further verified with more large-scale multi-centered randomized controlled trials, and its pharmacological mechanism remains to be further explored via more biomolecular experiments. The present article focuses on the recent advances in the application and studies of Ningmitai Capsule in the treatment of urological and andrological diseases.
Acute Disease ; Capsules ; Chronic Disease ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Epididymitis ; drug therapy ; Genital Diseases, Male ; drug therapy ; Humans ; Male ; Prostatitis ; drug therapy ; Seminal Vesicles ; Urinary Tract Infections ; drug therapy

OBJECTIVETo analyze risk factors, clinical features, outcomes and antibiotic resistance of Escherichia coli(E.coli) causing bloodstream infections in children.

METHODAll inpatients with E. coli positive blood culture in Beijing Children's Hospital from January 2012 to May 2014 were enrolled; 112 cases were included, 66 cases (58.9%) were male, and 46 cases(41.1%) were female. Age range was 2 days to 16 years. Among them, 43 cases (38.4%) were neonates, 19 cases (17.0%) aged from 1 month to 1 year, 14 cases (12.5%) were 1-3 years old, and 36 cases (32.1%) were over three years old. We analyzed the divisions to which the patients were admitted, source of infection, underlying diseases, clinical characteristics, antibiotic resistance, and treatment outcomes, etc.

RESULTForty-six cases (41.1%) were treated in division of hematology, 42 (37.5%) in neonatology, 9 (8.0%) in internal medicine, 8 (7.1%) in surgery, and 7 (6.3%) in pediatric intensive care unit. Sixty-five cases(58.0%) had underlying diseases. Fever was the most frequently presented symptom, as it was seen in 91 cases (81.3%); 52 cases(46.4%) had respiratory symptoms. Among these, 43 cases had pneumonia, 3 cases had respiratory failure, 3 cases were diagnosed as upper respiratory tract infection, 2 had pulmonary hemorrhage and 1 case had bronchitis. Twenty-six cases (23.2%)were diagnosed as severe sepsis and purulent meningitis separately, 14 cases(12.5%) had urinary tract infection. There were 73 (65.2%) strains inducing extended spectrum β-lactamases (ESBLs), of which 6 (8.2%) and 10 (13.7%) strains were resistant to amikacin and carbapenems respectively. Resistance rate against other antimicrobial agents varied from 64.6% to 100%.

OUTCOMES92 (82.1%) cases were cured or had improvement while 20 patients (17.9%) died or could not be cured at the end of treatment. Positive ESBLs (χ(2) = 6.609, P = 0.010), being complicated with severe sepsis (χ(2) = 40.253, P = 0.000) and requiring mechanical ventilation (χ(2) = 34.441, P = 0.000) indicate poor prognosis.

CONCLUSIONPatients with underlying diseases and newborns are susceptible to E. coli bloodstream infection. ESBLs infection, severe sepsis and mechanical ventilation indicate poor prognosis in E. coli blood stream infection. Clinicians may use carbapenems as empirical treatment for ESBLs infection. There may be carbapenem-resistant enterobacteriaceae strains infection if patients receiving treatment with carbapenems have no response.

Adolescent ; Bacteremia ; Carbapenems ; therapeutic use ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; Escherichia coli Infections ; blood ; drug therapy ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial ; Microbial Sensitivity Tests ; Pneumonia ; Urinary Tract Infections ; beta-Lactamases

PURPOSE: We investigated whether C-reactive protein (CRP) levels, urine protein-creatinine ratio (uProt/Cr), and urine electrolytes can be useful for discriminating acute pyelonephritis (APN) from other febrile illnesses or the presence of a cortical defect on 99mTc dimercaptosuccinic acid (DMSA) scanning (true APN) from its absence in infants with febrile urinary tract infection (UTI). MATERIALS AND METHODS: We examined 150 infants experiencing their first febrile UTI and 100 controls with other febrile illnesses consecutively admitted to our hospital from January 2010 to December 2012. Blood (CRP, electrolytes, Cr) and urine tests [uProt/Cr, electrolytes, and sodium-potassium ratio (uNa/K)] were performed upon admission. All infants with UTI underwent DMSA scans during admission. All data were compared between infants with UTI and controls and between infants with or without a cortical defect on DMSA scans. Using multiple logistic regression analysis, the ability of the parameters to predict true APN was analyzed. RESULTS: CRP levels and uProt/Cr were significantly higher in infants with true APN than in controls. uNa levels and uNa/K were significantly lower in infants with true APN than in controls. CRP levels and uNa/K were relevant factors for predicting true APN. The method using CRP levels, u-Prot/Cr, u-Na levels, and uNa/K had a sensitivity of 94%, specificity of 65%, positive predictive value of 60%, and negative predictive value of 95% for predicting true APN. CONCLUSION: We conclude that these parameters are useful for discriminating APN from other febrile illnesses or discriminating true APN in infants with febrile UTI.
Acute Disease ; C-Reactive Protein/*analysis ; Case-Control Studies ; Fever/microbiology ; Humans ; Infant ; Male ; Potassium/*urine ; Predictive Value of Tests ; Prospective Studies ; Proteinuria/diagnosis ; Pyelonephritis/*diagnosis/radionuclide imaging ; Sensitivity and Specificity ; Sodium/*urine ; *Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections/drug therapy/microbiology/*radionuclide imaging

PURPOSE: To report a case of endogenous endophthalmitis due to Klebsiella ozaenae, which is a rare causative organism of endophthalmitis. CASE SUMMARY: A 61-year-old male who was undergoing chemotherapy for hepatocellular carcinoma complained of sudden visual loss and ocular pain in his left eye for 2 days. On the first examination, the patient's visual acuity was counting fingers at 10 cm and the intraocular pressure was elevated to 29 mm Hg. Partial scleral rupture and choroidal prolapse were observed. Subretinal abscess was detected with increased echogenicity using ultrasonography. The patient complained of burning sensation on voiding and urinary frequency; subsequent urinalysis showed pyuria and bacteriuria. Intravitreal and systemic antibiotics were administered under the impression of endogenous endophthalmitis caused by urinary tract infection. Despite treatment, visual acuity decreased to no light perception in 4 days and intraocular pressure and pain was uncontrollable. Enucleation was performed and pus culture from the eye during surgery revealed Klebsiella ozaenae. CONCLUSIONS: Klebsiella ozaenae is a rare causative organism of endophthalmitis and shows a rapid progress and poor prognosis. Endogenous endophthalmitis must be highly suspected in patients with urinary tract infection as well as pyogenic liver abscess.
Abscess ; Anti-Bacterial Agents ; Bacteriuria ; Burns ; Carcinoma, Hepatocellular ; Choroid ; Drug Therapy ; Endophthalmitis* ; Fingers ; Humans ; Intraocular Pressure ; Klebsiella* ; Liver Abscess, Pyogenic ; Male ; Middle Aged ; Prognosis ; Prolapse ; Pyuria ; Rupture ; Sensation ; Suppuration ; Ultrasonography ; Urinalysis ; Urinary Tract Infections ; Visual Acuity

OBJECTIVETo study the preventive effect of herbal formulation on experimental murine urinary tract infection (UTI) induced by Dr Escherichia coli 11128.

METHODSE. coli 11128 carrying Dr fimbriae was isolated from patients with chronic pyelonephritis. The minimal inhibitory concentration (MIC) value of herbal solution for E. coli 11128 was determined for further studies. Forty C3H/HeJ mice were divided into the herb-treated group (n=20, given Chinese herbs by gavage at an average dose of 20 g/kg body weight daily 3 days before inoculation), and control group (n=20, given the same amount of distilled water by gavage). Three and 6 days after infection, bacteria were counted in the urine and the kidneys of the mice. Kidney histopathologic changes were evaluated. Neutrophils infiltration and accumulation were detected.

RESULTSThe MIC value of herbal solution was 0.1 g/mL for the E. coli 11128. In herb-treated mice, there was a significant reduction in bacterial counts in urine and colonization densities of kidneys. Microscopic studies revealed signs of inflammation in kidneys. In herb-treated mice, herbal administration resulted in significantly reduced neutrophilic infiltrates (P<0.05). The semi-quantitative scores for renal lesions were significantly lower (P<0.05).

CONCLUSIONProphylactic administration of herbal formulation potentiated the effect in partially preventing experimental murine ascending UTI.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Escherichia coli ; drug effects ; Escherichia coli Infections ; drug therapy ; prevention & control ; Female ; Kidney ; drug effects ; pathology ; Mice, Inbred C3H ; Phytotherapy ; Urinary Tract Infections ; drug therapy ; microbiology ; prevention & control

A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with appropriate investigations depending on individual risk factors. Simple uncomplicated cystitis responds very well to oral antibiotics, but complicated UTIs may require early imaging, and referral to the emergency department or hospitalisation to prevent urosepsis may be warranted. Escherichia coli remains the predominant uropathogen in acute community-acquired uncomplicated UTIs and amoxicillin-clavulanate is useful as a first-line antibiotic. Family physicians are capable of managing most UTIs if guided by appropriate history, investigations and appropriate antibiotics to achieve good outcomes and minimise antibiotic resistance.
Adult ; Aged ; Amoxicillin ; administration & dosage ; Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Clavulanic Acid ; administration & dosage ; Cystitis ; drug therapy ; Drug Resistance, Microbial ; Escherichia coli ; Escherichia coli Infections ; drug therapy ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Primary Health Care ; Risk Factors ; Urinary Tract Infections ; drug therapy ; epidemiology