The Immune Response to Urinary Tract Infections in Childhood

Jodal, U. (Institute of Medical Microbiology and Department of Pediatrics, University of Göteborg, Göteborg, Sweden). The immune response to urinary tract infections in childhood. I. Serological diagnosis of primary symptomatic infection in girls by indirect hemagglutination. Acta Paediatr Scand, 64:96, 1975.–Determination of antibodies to E. coli O antigen by indirect hemagglutination for detection of acute pyelonephritis was investigated in sequences of sera from 94 girls with their first known attack of symptomatic urinary tract infection. Using O antigen from the infecting bacterial strain or a standard strain increased antibody titres were found among pyelonephritis patients in 89% in unreduced sera (mainly 19 S antibodies) and in 81% in reduced sera (mainly 7 S antibodies) compared to a control material of 643 healthy children. Significant changes of these antibody titres occurred in 74 and 39% respectively. Analysis of maximal titres as well as titre changes in both unreduced and reduced sera showed diagnostic‐ally significant changes in two or more of these four parameters in 89% of patients with pyelonephritis. In contrast one parameter with such changes was found among the cystitis patients in only 5%. Employing a pool of 8 common O antigens, increased antibody titres were detected in 76% of patients with pyelonephritis. A larger pool of 68 antigens was no better and had a low capacity to detect 7 S antibodies. Optimal time for blood sampling was 2 to 3 weeks after onset of symptoms.