Matrix Metalloproteinase-2,Matrix Metalloproteinase-9,and Transforming Growth Factor Beta 1 Levels in Escherichia coli-Infected Rats with Acute Pyelonephritis

Objective:To investigate the expression of matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),and transforming growth factor beta 1(TGF beta 1)in the kidney tissue of rats with pyelonephritis and their relationship with pyelonephritis by establishing a rat model of acute pyelonephritis.Methods:80 male Wistar rats were randomly divided into a control group and an experimental group,with 40 rats each.The rats of the control group were injected with and saline and those of the experimental group were injected with 10μg/mL Escherichia coli(E.coli)and saline(1:100);the solutions for both groups were administered every 3 days for 7 days.The expressions of MMP-2,MMP-9 and TGF beta 1 in the kidney tissues of rats in each group were observed.Results:The expression of MMP-9 and TGF beta 1in the kidney tissue of rat acute pyelonephritis model rats was significantly higher than those of the control group(P<0.01);the MMP-9 mRNA content in the kidney tissue of the experimental group was significantly higher than that of the control group(P<0.05);the TGF beta 1 mRNA content in the renal tissue of the experimental group increased significantly compared to the(P<0.05);MMP-2,MMP-9 and TGF beta 1 began to express in the early stage of pyelonephritis until the complete formation of renal pelvic edema.The difference between groups was statistically significant(P<0.01).Conclusion:MMP-9 and TGF beta 1 are important factors regulating renal tubular epithelial cell injury and inflammatory response.

Epidemiological profile and management of acute pyelonephritis in the emergency department of a tertiary hospital: A retrospective observational study

Objective:To assess the clinical and microbiological characteristics as well as the risk factors of early readmission(<72 h)in acute pyelonephritis(APN)patients discharged from emergency department(ED).Methods:The medical records of patients discharged with a diagnosis of APN between January 1,2014 and December 31,2015 were reviewed.Epidemiological,clinical,ultrasound results,and laboratory characteristics were collected,and the risk factors of prompt readmission and non-prompt readmission were assessed.Results:A total of 423 APN patients were included.The mean age was(44.3±19.0)years.The bulk of the patients were women(79.9%),and 20%of cases had episodes previously.Urine cultures were requested in 77.5%of cases,with Escherichia coli being the most frequently isolated bacterium(80.1%).Resistance to one or more antibiotics was found in 68.1%of the bacteria.The most widely used antibiotics were beta-lactam with beta-lactamases inhibitor(46%),and aminoglycosides in 24.4%of cases.Altogether,73.5%of the patients received antibiotic treatment in the ED,and 46.8%of the patients were discharged.Furthermore,6.1%of the patients discharged from the ED had re-admission without associated risk factors.Conclusions:Given the high rate of resistance,it is important to know the profile of antibiotics in different areas.Likewise,the administration of antibiotics in the ED is useful in the prevention of early readmissions of APN(<72 h).

Does delaying ureteral stent placement lead to higher rates of preoperative acute pyelonephritis during pregnancy?

BACKGROUND Pregnancy with renal colic may cause pyelonephritis,decreased renal function,systemic infection and even shock in pregnant women,and cause premature birth and other adverse pregnancy outcomes.When surgery is necessary,the relationship between timing of the operation and the outcome of the mother and child are not known.AIM To investigate the association between time to ureteral stent placement and clinical outcomes of patients with renal colic during pregnancy.METHODS In this retrospective study,pregnant women with renal colic who underwent surgery were studied.Maternal preoperative acute pyelonephritis(PANP),pregnancy outcome,and length of hospital stay(LOS)were compared between the two groups.RESULTS 100 patients were included in the analysis,median age was 30 years.Median time to ureteral stent placement was 48 h(interquartile range,25-96 h),and 32 patients(32%)were diagnosed with PANP.PANP was closely related to hospitalization costs,re-admission to the hospital due to urinary tract infection after surgery and premature delivery.Multivariate analysis found that stone location and time from pain to admission were related to PANP.CONCLUSION Both early and delayed surgery are safe and effective for the treatment of renal colic during pregnancy.Early surgery may be superior to a delayed procedure due to shorter LOS.For pregnant patients with renal colic,delayed surgery within 48 h is not related to the clinical outcome of the mother and child.However,the time from pain to hospital admission was related to PANP.