TY - JOUR
T1 - Bacteriology and ultrastructure of the bladder in patients with urinary tract infections
AU - Elliott, T. S.J.
AU - Reed, L.
AU - Slack, R. C.B.
AU - Bishop, M. C.
PY - 1985/11
Y1 - 1985/11
N2 - Tissue obtained by biopsy of the bladder from 33 patients with various urinary tract symptoms was studied by conventional bacteriological techniques and by scanning electron microscopy (SEM). All the patients had recurrent urinary tract symptoms which had not completely responded to antibiotic therapy. Eleven of the patients had ≥, 108 colony-forming units (CFU) of bacteria/1 urine; six had between 106 and 107 CFU/1, and 16 were abacteruric. Bacteria were isolated, however, from the tissue obtained by biopsy from eight of the 16 patients with sterile urine and bacteria were seen on the uro-epithelium in 14 of these patients. By comparison, in all samples of tissue obtained from the 11 patients with ≥, 108 CFU/1 of urine bacteria were seen on the uro-epithelium and from nine of these, bacteria were subsequently grown. Fastidious organisms were not isolated from any of the patients. The uro-epithelium of all those studied was also shown to be grossly disrupted with increased disturbance and loss of the epithelial cells when compared with tissue obtained from uninfected patients. The degree of uro-epithelial disturbance was greatest in patients with histories of urinary tract infections lasting more than 4 months. The findings suggest that bacteriological examination of the urine does not always reflect bacterial infection on the bladder surface nor disruption of the uro-epithelium. The changes on the bladder surface may explain the patients' symptoms. In view of the results, a scheme is proposed that explains the development of symptoms in patients with urinary tract and bladder infections.
AB - Tissue obtained by biopsy of the bladder from 33 patients with various urinary tract symptoms was studied by conventional bacteriological techniques and by scanning electron microscopy (SEM). All the patients had recurrent urinary tract symptoms which had not completely responded to antibiotic therapy. Eleven of the patients had ≥, 108 colony-forming units (CFU) of bacteria/1 urine; six had between 106 and 107 CFU/1, and 16 were abacteruric. Bacteria were isolated, however, from the tissue obtained by biopsy from eight of the 16 patients with sterile urine and bacteria were seen on the uro-epithelium in 14 of these patients. By comparison, in all samples of tissue obtained from the 11 patients with ≥, 108 CFU/1 of urine bacteria were seen on the uro-epithelium and from nine of these, bacteria were subsequently grown. Fastidious organisms were not isolated from any of the patients. The uro-epithelium of all those studied was also shown to be grossly disrupted with increased disturbance and loss of the epithelial cells when compared with tissue obtained from uninfected patients. The degree of uro-epithelial disturbance was greatest in patients with histories of urinary tract infections lasting more than 4 months. The findings suggest that bacteriological examination of the urine does not always reflect bacterial infection on the bladder surface nor disruption of the uro-epithelium. The changes on the bladder surface may explain the patients' symptoms. In view of the results, a scheme is proposed that explains the development of symptoms in patients with urinary tract and bladder infections.
UR - http://www.scopus.com/inward/record.url?scp=0022352010&partnerID=8YFLogxK
U2 - 10.1016/S0163-4453(85)92997-4
DO - 10.1016/S0163-4453(85)92997-4
M3 - Article
C2 - 3936879
AN - SCOPUS:0022352010
SN - 0163-4453
VL - 11
SP - 191-196,IN3-IN6,197-199
JO - Journal of Infection
JF - Journal of Infection
IS - 3
ER -
