title: Epidemic outbreaks of acute pyelonephritis caused by nosocomial spread of P fimbriated Escherichia coli in children.
abstract: In a study of pyelonephritis in children less than two years of age we found a high incidence of acute first-time pyelonephritis among children who had been previously cared for in a particular hospital neonatal ward. In 1981 and 1982 more than 50% of the children with pyelonephritis from the referral area of Danderyd Hospital (Danderyd, Sweden) had previously attended this particular neonatal ward; the expected incidence was 15% (P less than .001). The majority of these cases of pyelonephritis were caused by Escherichia coli that were P fimbriated and of serotype O6:K5. An E. coli strain with the same characteristics was found in the stools of personnel in the neonatal ward and in a high proportion of the stools and cord stumps of neonates in the ward. These findings support the opinion that certain P fimbriated E. coli clones may be nosocomially spread and cause epidemic outbreaks of pyelonephritis and that fecal colonization with such E. coli predisposes to this disease.
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D004196:Disease Outbreaks / Q000453:epidemiology*; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects / Q000254:growth & development / Q000648:ultrastructure*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005243:Feces / Q000382:microbiology; D005260:Female; D010861:Fimbriae, Bacterial; D006757:Hospital Units; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010564:Personnel, Hospital; D011704:Pyelonephritis / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D013548:Sweden; D014472:Umbilicus / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents