Common Enterobacterial Antigen in Human Chronic Pyelonephritis and Interstitial Nephritis

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Abstract
An indirect immunofluorescent technic was used to search for common enterobacterial antigen in kidney specimens from patients with bacterial and "abacterial" pyelonephritis, chronic interstitial nephritis and nonspecific renal scars. Control studies showed adequate staining of enteric bacteria in smears and in tissues of animals with acute experimental Escherichia coli and proteus pyelonephritis. Bacterial antigen was unequivocally found in only one of nine kidneys with chronic pyelonephritis, and was uniformly absent in chronic interstitial nephritis and in nonspecific renal scars. Antigen was present in three of five kidneys with acute pyelonephritis caused by enteric organisms and in one of two with xanthogranulomatous pyelonephritis. These findings are in contrast with those of others showing common antigen in the majority (six out of seven) of kidneys with chronic "abacterial" pyelonephritis. Because of the relative insensitivity of the method the data do not exclude a role for bacteria but suggest continued search for other causes of interstitial renal diseases and better methods for their differential diagnosis. (N Engl J Med 289:830–835, 1973)

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