P-fimbriae studies on the diagnosis and prevention of acute pyelonephritis.

Theoretically there are several ways to prevent pyelonephritis and renal scarring caused by P-fimbriated Escherichia coli. Screening for individuals at risk, e.g. those carrying P-fimbriated pyelonephritogenic E. coli or those with high receptor density on their uroepithelial cells, could perhaps define a population where prophylaxis with a receptor analogue or vaccination with P-fimbriae may be relevant. Epidemiological measures in neonatal and maternity wards may prevent the nosocomial spread of virulent bacteria and reduce the number of colonized infants. However, no such methods have so far had any proven clinical relevance, and today, the important concern is still to try by conventional means--as we have always done--to get an early diagnosis and to treat the patient without delay.