Antibody-coated bacteria in persistent and recurrent urinary tract infections

Antibody-coated bacteria in persistent and recurrent urinary tract infections. Multiple urine specimens from 24 patients (16 with pyelonephritis; 8 with cystitis) were tested over a period of time ranging from 2 months to over 3 years to determine whether the results of the urine fluorescent antibody (FA) test changed with persistent or recurrent infection. These 24 patients, who were a part of our initially reported study of antibody-coated bacteria, had returned to the clinic because of continued problems with infection. The FA test results remained positive for 12 patients who had persistent or recurrent kidney infections involving the same bacterial strain. Five other patients had recurrences caused by strains different from the bacterial isolate involved in the previous kidney infection; these 5 patients had a total of 27 reinfection episodes, and 13 of the episodes were associated with negative FA tests. Direct localization studies showed that, in the course of persisting infection, changes in the FA test results from negative to positive were associated with the ascen-dence of infection to the kidney. Unbound (excess, free) antibacterial antibody detected in the urines from 12 of 14 patients with renal infection was found to be weakly cross reactive with bacteria other than the one causing the infection; this antibody persisted with continued infection, although it was short-lived after the infection had subsided, disappearing by the 4th month. FA test results were consistently negative for 8 patients with recurrent episodes of cystitis but without past history or evidence of pyelonephritis. Bactéries recouvertes d'anticorps dans les infections urinaries persistantes et récidivantes. De nombreux échantillons d'urine de 24 malades (16 atteints de pyélonéphrite et 8 de cystite) ont été étudiés sur une période allant de 2 mois à plus de 3 ans, pour savoir si les résultats de la recherche d'anticorps fluorescents (FA) sont modifiés par l'infection persistante ou récidivante. Ces 24 malades, qui faisaient partie de notre étude antérieure sur les Bactéries recouvertes d'anticorps, sont revenus consulter en raison de la persistance de problèmes d'infection. Le test FA est resté positif pour 12 malades qui avaient des infections rénales persistantes ou récidivantes impliquant la même souche bactérienne. Cinq autres malades ont eu des récidives déterminées par une souche différente de celle isolée au cours de l'infection rénale antérieure. Ces 5 malades ont