Stenqvist K, Lidin-Janson G, Sandberg T, Edén C S
Department of Infectious Diseases, Ostra Sjukhuset, Sweden.
Scand J Infect Dis. 1989;21(2):193-9. doi: 10.3109/00365548909039968.
The association of bacterial virulence with the host response to bacteriuria was evaluated in 70 pregnant women with acute pyelonephritis or bacteriuria detected at screening. Patients infected with Escherichia coli attaching to Gal alpha 1----4Gal beta-containing receptors, had significantly higher levels of C-reactive protein and lower renal concentrating capacity than patients infected with strains lacking this specificity. The renal concentrating capacity ranged from 419-1151 mOsm/kg in the women with bacteriuria on screening. 5/11 women with a renal concentrating capacity less than or equal to 784 mOsm/kg were infected with Gal alpha 1----4Gal beta-specific bacteria, compared to 0/16 of patients who concentrated the urine greater than 784 mOsm/kg. According to earlier studies the risk for progression to pyelonephritis and recurrences during pregnancy was increased in bacteriuric women with a reduced renal concentrating capacity. The present study demonstrates that this risk group can be identified in part by the properties of the infecting E. coli strains.
在70名在筛查时检测出患有急性肾盂肾炎或菌尿症的孕妇中，评估了细菌毒力与宿主对菌尿反应之间的关联。感染了附着于含Galα1----4Galβ受体的大肠杆菌的患者，其C反应蛋白水平显著更高，且肾浓缩能力低于感染缺乏这种特异性菌株的患者。在筛查时患有菌尿症的女性中，肾浓缩能力范围为419 - 1151 mOsm/kg。肾浓缩能力小于或等于784 mOsm/kg的11名女性中有5名感染了Galα1----4Galβ特异性细菌，而尿液浓缩大于784 mOsm/kg的16名患者中则有0名感染。根据早期研究，肾浓缩能力降低的菌尿症女性在孕期进展为肾盂肾炎和复发的风险增加。本研究表明，这一风险群体可部分通过感染的大肠杆菌菌株特性来识别。
