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Effect of alkalinisation and increased fluid intake on bacterial phagocytosis and killing in urine

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Abstract

The effect of alkalinisation and increased fluid intake on bacterial phagocytosis and killing in urine was studied. Phagocytosis ofEscherichia coli andStaphylococcus saprophyticus by polymorphonuclear neutrophils (PMN) took place in only one of three first voided early morning urine samples from volunteers, and no bacterial killing occurred. This was attributed to the high osmolality (690 to 720 mOsm) and low pH of the early morning urine; two samples were pH 5.8 and the third, in which phagocytosis occurred, was pH 6.4. Afternoon urine samples from the same volunteers had lower osmolality and a higher pH, with a high rate of phagocytosis (≥88 %) and 55–69 % killing. PMN remained viable (mean 94 %) after exposure for 1 h to both early morning and afternoon urine. Volunteers taking 4 g sodium citrate showed a mean rise of urinary pH of 1 unit. Water loading in patients with urinary tract infections produced a bacteria to neutrophil ratio conducive to bacterial killing, bacterial counts being reduced by a mean of 2.5 logs after 1–3 h without a corresponding reduction in neutrophils. Thus, raising the pH and reducing the osmolality of urine increases the ability of neutrophils to eliminate infecting organisms.

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References

  1. Fukushi Y, Orikasa S: The role of intravesical polymorphonuclear leukocytes in experimental cystitis. Investigative Urology 1981, 18: 471–474.

    PubMed  Google Scholar 

  2. Maeda S, Deguchi T, Kanimoto Y, Kuriyama M, Kawada Y, Nishiura T: Studies on the phagocytic function of urinary leukocytes. Journal of Urology 1983, 129: 427–429.

    PubMed  Google Scholar 

  3. Chernew I, Braude AI: Depression of phagocytosis by solutes in concentrations found in the kidney and urine. Journal of Clinical Investigation 1962, 41: 1945–1953.

    PubMed  Google Scholar 

  4. Bryant RE, Sutcliffe MC, McGee ZA: Human polymorphonuclear leukocyte function in urine. Yale Journal of Biology and Medicine 1973, 46: 113–124.

    PubMed  Google Scholar 

  5. Suzuki Y, Toyoto S, Magima K, Fukushi Y, Orikasa S: Studies of anti-bacterial defense mechanism of urinary bladder. Japanese Journal of Urology 1986, 77: 574–580.

    PubMed  Google Scholar 

  6. Gargan RA, Brumfitt W, Hamilton-Miller JMT: Effect of pH and osmolality on in vitro phagocytosis and killing by neutrophils in urine. Infection and Immunity 1993, 61: 8–12.

    PubMed  Google Scholar 

  7. Barnett GD, Blume FE: Alkaline tides. Journal of Clinical Investigation 1938, 17: 159–165.

    Google Scholar 

  8. Stanbury SW, Thomson AE: Diurnal variations in electrolyte excretion. Clinical Science 1951, 10: 267–293.

    PubMed  Google Scholar 

  9. Clawson CC, Repine JE: Quantitation of maximal bactericidal capability in human neutrophils. Journal of Laboratory and Clinical Medicine 1976, 88: 316–327.

    PubMed  Google Scholar 

  10. Eggleton P, Gargan R, Fisher D: Rapid method for the isolation of neutrophils in high yield without the use of dextran or density gradient polymers. Journal of Immunological Methods 1989, 121: 105–113.

    Article  PubMed  Google Scholar 

  11. Ford WL: The preparation and labelling of lymphocytes. In: Weir DM (ed): Handbook of experimental immunology. Volume 2. Blackwell Scientific Publications, Oxford, 1978, p. 23.1–23.22.

    Google Scholar 

  12. Gargan RA, Brumfitt W, Hamilton-Miller JMT: Preopsonisation ofEscherichia coli induces resistance to neutrophil killing in serum and urine: relationship to growth phase. Journal of Medical Microbiology 1991, 35: 12–17.

    PubMed  Google Scholar 

  13. Gargan RA, Brumfitt W, Hamilton-Miller JMT: Failure of water to lyse polymorphonuclear neutrophils completely: role of pH and implications for assessment of bacterial killing. Journal of Immunological Methods 1989, 124: 289–291.

    Article  PubMed  Google Scholar 

  14. Horwitz MA, Silverstein SC: Influence ofEscherichia coli capsule on complement fixation and on phagocytosis and killing by human phagocytes. Journal of Clinical Investigation 1980, 65: 82–94.

    PubMed  Google Scholar 

  15. Matsumoto T, Kumazawa J, Van der Auwera P: Suppression of leukocyte function and intracellular content of ATP in hyperosmotic condition comparable to the renal medulla. Journal of Urology 1989, 142: 399–402.

    PubMed  Google Scholar 

  16. Guthinger WP, Pranikoff K, Cockett ATK: Cytochrome staining of leukocytes in urine sediment. Urology 1977, 9: 630–633.

    Article  PubMed  Google Scholar 

  17. Gillon G, Small M, Medalia O, Aronson M: Sequential study of bacterial clearance in experimental cystitis. Journal of Medical Microbiology 1984, 18: 319–326.

    PubMed  Google Scholar 

  18. Suzuki Y, Fukushi Y, Orikasa S, Kumagai K: Opsonic effect of normal and infected human urine on phagocytosis ofEscherichia coli and yeasts by neutrophils. Journal of Urology 1982, 127: 356–360.

    PubMed  Google Scholar 

  19. Gibb AP, Edmond DM: Urinary IgG antibody against mixed heat-killed coliform antigen and lipopolysaccharide core antigen. Journal of Clinical Pathology 1992, 45: 161–164.

    PubMed  Google Scholar 

  20. Berg C, Larsson L, Tiselius HG: The effects of a single evening dose of alkaline citrate on urine composition and calcium stone formation. Journal of Urology 1992, 148: 79–985.

    Google Scholar 

  21. Brumfitt W, Hamilton-Miller JMT, Cooper J, Raeburn A: Relationship of urinary pH to symptoms of cystitis. Postgraduate Medical Journal 1990, 66: 727–729.

    PubMed  Google Scholar 

  22. Spooner JB: Alkalinisation in the management of cystitis. Journal of International Medical Research 1984, 12: 30–34.

    PubMed  Google Scholar 

  23. Munday PE, Savage S: Cymalon in the management of urinary tract symptoms. Genitourinary Medicine 1990, 66: 461.

    Google Scholar 

  24. Mabeck CE: Treatment of uncomplicated urinary tract infection in non-pregnant women. Postgraduate Medical Journal 1972, 48: 69–75.

    PubMed  Google Scholar 

  25. Stamm WE, Running K, McKevitt M, Counts GW, Turck M, Holmes KK: Treatment of the acute urethral syndrome. New England Journal of Medicine 1981, 304: 956–958.

    PubMed  Google Scholar 

  26. Dicker SE: Mechanisms of urine concentration and dilution in mammals. Edward Arnold, London. 1970, 1–15.

    Google Scholar 

  27. Cattell WR, Kelsey Fry I, Spiro FI, Sardeson JM, Sutcliffe MB, O'Grady F: Effect of diuresis and frequent micturition on the bacterial content of infected urine: a measure of competence of intrinsic hydrokinetic clearance mechanisms. British Journal of Urology 1970, 42: 290–295.

    PubMed  Google Scholar 

  28. Leijh PCJ, Van Den Barsclaar MT, Dubbeldeman-Rempt I, Van Furth R: Kinetics of intracellular killing ofStaphylococcus aureus andEscherichia coli by human granulocytes. European Journal of Immunology 1980, 10: 750–757.

    PubMed  Google Scholar 

  29. Tsujimura S, Otaguro K, Sasaki M, Tanaka R: Chemotactic factors as cause of polyleukocyte urine in urinary tract infection: chemotactic activity of urinary protein fraction. Investigative Urology 1980, 17: 269–272.

    PubMed  Google Scholar 

  30. Elgebaly SA, Allam ME, Walzak MP, Oselinsky D, Gillies C, Yamase H: Urinary neutrophil chemotactic factors in interstitial cystitis patients and a rabbit model of bladder inflammation. Journal of Urology 1992, 147: 1382–1387.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Microbiology, The Royal Free Hospital and School of Medicine, Pond Street, Hampstead, NW3 2QG, London, UK

    R. A. Gargan, J. M. T. Hamilton-Miller & W. Brumfitt

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  1. R. A. Gargan
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  2. J. M. T. Hamilton-Miller
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  3. W. Brumfitt
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Gargan, R.A., Hamilton-Miller, J.M.T. & Brumfitt, W. Effect of alkalinisation and increased fluid intake on bacterial phagocytosis and killing in urine. Eur. J. Clin. Microbiol. Infect. Dis. 12, 534–539 (1993). https://doi.org/10.1007/BF01970959

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