Summary
Theoretically there are several ways to prevent pyelonephritis and renal scarring caused by P-fimbriatedEscherichia coli. Screening for individuals at risk, e.g. those carrying P-fimbriated pyelonephritogenicE. 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.
Zusammenfassung
Theoretisch gibt es verschiedene Möglichkeiten, die durch P-Fimbrien-tragendeEscherichia coli verursachte Pyelonephritis und renale Narbenbildung zu verhüten. Ein Screening auf Risikopersonen, beispielsweise diejenigen, die mit P-Fimbrien-tragenden pyelonephritogenenE. coli besiedelt sind oder deren uroepitheliale Zellen eine hohe Rezeptordichte haben, könnte vielleicht eine Gruppe definieren, bei der eine Impfung mit einem Rezeptor-Analogon oder mit P-Fimbrien wichtig wäre. Epidemiologische Maßnahmen auf Neugeborenen- und Entbindungsstationen könnten die nosokomiale Verbreitung von virulenten Bakterien verhüten und die Anzahl besiedelter Säuglinge vermindern. Jedoch ist bisher für keine der genannten Methoden der Beweis der klinischen Effizienz erbracht, und derzeit ist es immer noch entscheidend, konventionelle Methoden einzusetzen, um, wie wir es immer getan haben, frühzeitig die Diagnose zu stellen und den Patienten ohne Verzug zu behandeln.
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The present version — although unfortunately much delayed — incorporates latest findings on the subject as first oulined at Sils Maria.
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Källenius, G., Svenson, S.B., Jacobson, S.H. et al. P-fimbriae studies on the diagnosis and prevention of acute pyelonephritis. Infection 13, 159–162 (1985). https://doi.org/10.1007/BF01642881
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DOI: https://doi.org/10.1007/BF01642881