[Bacteriology of urinary germs responsible of pyelonephritis].
Cytobacteriological examination of urine is indispensable in patients with acute or chronic pyelonephritis. Direct examination through the microscope is fundamental in acute pyelonephritis where immediate antibiotic therapy is mandatory. A significant bacteriuria points to an obstacle to urine flow. Escherichia coli is the most common pathogen in acute and chronic pyelonephritis. Isolating a Proteux strain suggests that lithiasis is present. Pseudomonas aeruginosa always has a nosocomial origin and is often responsible for chronic asymptomatic pyelonephritis. Staphylococci and enterococci may produce pyelonephritis, notably when it is associated with urinary stones. Since hospital- or community-acquired strains of E. Coli are strongly resistant to aminopenicillins and cotrimoxazole, these antibacterials must not be used as first-line treatment of pyelonephritis.
Consultation de pathologie infectieuse, hôpital Saint-Joseph, Paris.
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Guibert
D000208:Acute Disease; D001431:Bacteriological Techniques; D001437:Bacteriuria / Q000382:microbiology; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011704:Pyelonephritis / Q000382:microbiology*