6533b7d2fe1ef96bd125e95e

RESEARCH PRODUCT

UROEPITHELIAL DEFENSE IN CHILDREN WITH URINARY TRACT INFECTIONS (UTI)

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It is well accepted that obstructive uropathy causes UTI.In patients without urological anomalies a host defense defect of the uroepithelial cells (UEC) may result in increased susceptibility to bacterial infections.Even in patients with vesicourethral reflux (VUR) and recurrent UTI the postulated defense mechanism may be impaired since a significant proportion of these patients still suffer from UTI after surgical therapy.Therefore the influence of UEC on bacterial growth was investigated in 5 groups of children: healthy donors,children with neurogenic bladder due to myelomeningocele (MMC),patients with asymptomatic bacteriuria (ABU;without obstructive uropathy) and patients with VUR after successful surgery.The last group consisted of patients with and without further recurrent UTI.- 105 UEC desquamated in fresh morning urine were cocultivated (37°C,5%CO2) with 108E.coli bacteria/ml RPMI medium (uropathogenic,MR-piliated).After 30,60 and 90 minutes,samples of the bacteria-cell suspension were transferred to liquid agar plates.Bacterial colonies were visually determined after breeding for 18 hours.-Significant suppression of the E.coli growth rate was evident using UEC from healthy controls,from MMC patients and from VUR patients without UTI.In contrast,UEC from all ABU patients as well as from VUR patients still suffering from UTI did not suppress bacterial growth.The results demonstrate a relevant UEC defense mechanism in healthy donors which can be overcome by uropathies such as neurogenic bladder dysfunction. Recurrencies of UTI in ABU- as well as in successfully operated VUR-patients may be explained by a deficient UEC defense mechanism.