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Experimental pyelonephritis in the monkey. VII. Ascending pyelonephritis in the absence of vesicoureteral reflux
Abstract:
Six adult male nonrefluxing monkeys were experimentally infected by inoculation of P-fimbriated E. coli into the bladder. Eight control monkeys were inoculated with a non-P-fimbriated E. coli strain. Inoculation with the P-fimbriated E. coli resulted in marked leukocytosis, prolonged bacteriuria and loss of renal function with a 66 per cent incidence of pyelonephritis. Death secondary to bilateral pyelonephritis was seen in 2 monkeys inoculated with P-fimbriated E. coli. Pyelonephritis was not seen in any of the monkeys inoculated with non-P-fimbriated E. coli. The study shows that ascending pyelonephritis can occur in monkeys in the absence of vesicoureteral reflux.
Insights
P-fimbriated E. coli causes pyelonephritis in monkeys without reflux. This study demonstrates that ascending pyelonephritis can occur even without vesicoureteral reflux, challenging previous assumptions.
Area of Science:
- Urology
- Microbiology
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are common, with pyelonephritis being a severe form.
- Vesicoureteral reflux (VUR) has been considered a major risk factor for developing pyelonephritis.
- The role of specific bacterial virulence factors in ascending UTIs requires further investigation.
Purpose of the Study:
- To investigate the role of P-fimbriated Escherichia coli (E. coli) in causing pyelonephritis in the absence of vesicoureteral reflux.
- To determine if P-fimbriated E. coli can cause ascending urinary tract infections leading to kidney damage.
Main Methods:
- Experimental infection of nonrefluxing monkeys with P-fimbriated E. coli.
- Control group inoculated with non-P-fimbriated E. coli.
- Monitoring for leukocytosis, bacteriuria, renal function, and incidence of pyelonephritis.
Main Results:
- Infection with P-fimbriated E. coli led to significant leukocytosis, prolonged bacteriuria, and impaired renal function.
- A 66% incidence of pyelonephritis was observed in the P-fimbriated E. coli group.
- Two deaths occurred due to bilateral pyelonephritis in monkeys infected with P-fimbriated E. coli.
- No pyelonephritis was observed in the control group inoculated with non-P-fimbriated E. coli.
Conclusions:
- P-fimbriated E. coli is capable of causing ascending pyelonephritis in the absence of vesicoureteral reflux.
- Bacterial virulence factors, such as P-fimbriae, play a critical role in the pathogenesis of pyelonephritis.
- This finding has implications for understanding UTI development and treatment strategies.