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Studies on the antibody response to E. Coli O-antigens in children with urinary tract infections
Insights
Children with kidney involvement in urinary tract infections show a high E. coli antibody response. A polyvalent E. coli antigen is a useful substitute when urinary cultures are negative.
Area of Science:
- Immunology
- Pediatrics
- Microbiology
Background:
- Urinary tract infections (UTIs) are common in children.
- Escherichia coli (E. coli) is the primary causative agent of UTIs.
- Assessing the antibody response to E. coli is crucial for understanding infection severity and guiding treatment.
Purpose of the Study:
- To measure the E. coli antibody response in children with acute and chronic UTIs.
- To investigate the correlation between antibody response and renal involvement in pediatric UTIs.
- To evaluate substitute E. coli antigens for serological testing in cases with negative urine cultures.
Main Methods:
- Passive haemagglutination technique was employed to determine E. coli antibody titres.
- Antibody titres were measured in children with acute/chronic UTIs (with/without renal involvement) and in healthy controls.
- Three E. coli antigen sources were tested: urinary strains, fecal strains, and a polyvalent standard antigen.
Main Results:
- Markedly high E. coli antibody response was observed in acute UTIs with renal involvement and chronic pyelonephritis.
- Slightly elevated antibody response was noted in acute UTIs without renal involvement.
- A polyvalent E. coli antigen served as a valuable substitute, yielding comparable titres to urinary antigens in approximately 63% of cases, outperforming fecal antigens (52%).
Conclusions:
- The E. coli antibody response is a significant indicator of UTI severity, particularly with renal involvement.
- A polyvalent E. coli antigen offers a promising alternative for serological diagnosis when urine cultures are negative.
- Further research into standardized antigen preparations could enhance diagnostic accuracy in pediatric UTIs.
Abstract:
A passive haemagglutination technique was used to measure the E. coli antibody response in children with acute and chronic urinary tract infections with or without renal involvement. The E. coli antibody titre was also determined in sera of control normal children. In acute infections with renal involvement there was markedly high antibody response whereas in acute infections without renal involvement the rise in the antibody response to E. coli was only slight. In patients with chronic pyelonephritis the titres were also markedly high. E. coli antigens from 3 different sources were used in an attempt to find a substitute antigen for cases with negative urinary cultures. The 3 antigens used were urinary strains (only in patients with positive urinary cultures), patient's faecal strain and a polyvalent standard E. coli antigen. The faecal antigens gave results similar to the urinary ones in only 52% while the polyvalent antigen was found to be a more valuable substitute antigen giving equal titres to those with the urinary antigens in about 63% of the cases.