Antibodies to Tamm-Horsfall protein associated with renal damage and urinary tract infections in adults

Autoantibodies to Tamm-Horsfall protein associated with renal damage and urinary tract infections in adults. Forty-seven adults with urinary tract infection (UTI), 9 with recent acute pyelonephritis and 38 with previous renal infection, were investigated for the presence of autoantibodies to Tamm-Horsfall protein (THP). All patients except 6 had or had had vesicoureteric reflux (VUR). In patients with recent acute pyelonephritis, only IgA antibodies were significantly elevated. Among the patients with previous UTI, more than 6 months before the time of testing, a graded response was found for IgG and IgM specific antibodies, with the lowest value in those with renal damage and elevated serum creatinine and the highest in those with a normal X-ray. A negative correlation was found between IgG antibodies to THP and elevated serum creatinine (r = -0.76, P < 0.02). No significant correlation was found between VUR itself and antibodies to THP. A low IgG antibody level to THP in patients with a history of previous UTI seems to be a useful indicator of renal scarring. Possible immunologic mechanisms behind the low antibody level and the renal damage are discussed.Auto-anticorps anti-protéine de Tamm-Horsfall associés à des lésions rénales et à des infections urinaires chez l'adulte Quarante-sept adultes atteints d'infection urinaire, 9 ayant une pyélonéphrite aiguë récente et 38 une infection rénale antérieure ont été étudiés pour la présence d'auto-anticorps anti-protéine de Tamm-Horsfall (THP). Tous les malades sauf six avaient ou avaient eu un reflux vésico-urétéral. Chez les malades ayant un antécédent récent de pyélonéphrite seul les anti-corps IgA étaient significativement élevés. Parmi les malades dont l'antécédent d'infection urinaire remontait à plus de six mois une réponse a été obtenue pour les anti-corps spécifiques IgG et IgM, avec la valeur la plus faible chez ceux qui étaient atteints de lésions rénales et avaient une créatininémie élevée et la valeur la plus élevée chez ceux qui étaient indemnes de lésions radiologiques. Une corrélation négative a été observée entre les anti-corps IgG anti THP et l'augmentation de la créatininémie (r = -0,76, P < 0,02). Il n'a pas été observé de corrélation significative entre le reflux par lui-même et les anti-corps anti THP. Un taux faible d'anti-corps IgG anti THP chez des malades ayant des antécédents d'infection urinaire peut être un indicateur utile de lésions rénales. Les mécanismes immunologiques qui peuvent sous tendre le taux faible d'anti-corps et les lésions rénales sont discutés

Increase of beta-Lactam-Resistant Invasive Haemophilus influenzae in Sweden, 1997 to 2010

The proportions of Haemophilus influenzae resistant to ampicillin and other beta-lactam antibiotics have been low in Sweden compared to other countries in the Western world. However, a near-doubled proportion of nasopharyngeal Swedish H. influenzae isolates with resistance to beta-lactams has been observed in the last decade. In the present study, the epidemiology and mechanisms of antimicrobial resistance of H. influenzae isolates from blood and cerebrospinal fluid in southern Sweden from 1997 to 2010 (n = 465) were studied. Antimicrobial susceptibility testing was performed using disk diffusion, and isolates with resistance to any tested beta-lactam were further analyzed in detail. We identified a significantly increased (P = 0.03) proportion of beta-lactam-resistant invasive H. influenzae during the study period, which was mainly attributed to a significant recent increase of beta-lactamase-negative beta-lactam-resistant isolates (P = 0.04). Furthermore, invasive beta-lactamase-negative beta-lactam-resistant H. influenzae isolates from 2007 and onwards were found in higher proportions than the corresponding proportions of nasopharyngeal isolates in a national survey. Multiple-locus sequence typing (MIST) of this group of isolates did not completely separate isolates with different resistance phenotypes. However, one cluster of beta-lactamase-negative ampicillin-resistant (BLNAR) isolates was identified, and it included isolates from all geographical areas. A truncated variant of a beta-lactamase gene with a promoter deletion, bla(TEM-1)-P Delta dominated among the beta-lactamase-positive H. influenzae isolates. Our results show that the proportions of beta-lactam-resistant invasive H. influenzae have increased in Sweden in the last decade

Helicobacter pylori antibodies and iron deficiency in female adolescents.

OBJECTIVE: Iron deficiency (ID) is a common clinical problem worldwide, affecting primarily females. Helicobacter pylori (HP) infection has been shown to be associated with ID. The objective of this study was to define the prevalence of HP antibodies in female adolescents, and to find out if there was a correlation between HP infection and ID. The secondary aim was to study if regularly performed sporting activity, have any association to HP infection, in itself. DESIGN: A controlled clinical trial. SETTING: A senior high school in Gothenburg, Sweden. SUBJECTS: All female athletes at a senior high school for top-level athletes were offered to take part, and 56 athletes took part in the study. The control group consisted of a random sample of age-matched non-athlete students of which 71 entered the study. MAIN OUTCOME MEASURES: Iron deficiency (ID) and iron deficiency anaemia (IDA) were defined by the use of levels of haemoglobin, serum iron, total iron-binding capacity, transferrin saturation, and serum ferritin, as previously described. HP IgG-antibodies were detected by ELISA. RESULTS: 18 of 127 (14%) adolescent females had antibodies against HP. Only 3% had IDA, while 50% had ID. In total, 66% of the HP positive females had ID compared to 48% of the negative females (p = 0.203). No correlation between sporting activity and HP infection was found. Regarding ethnicity, 11/28 of subjects from medium-high risk areas were HP-positive, compared to 7/99 coming from low-risk areas (p<0.001). CONCLUSION: The main finding of this study is that the prevalence of HP IgG antibodies was 14% in adolescent females. We could not find any difference regarding frequency of ID and IDA, between HP positive and negative individuals. Ethnicity is of great importance for the risk of HP infection, while sporting activity itself seems to have no association to HP-infection