title: Interleukin-6 and disease severity in patients with bacteremic and nonbacteremic febrile urinary tract infection.
abstract: An interleukin-6 (IL-6) response was detected in 81 patients with febrile urinary tract infections (UTIs). Bacteremic patients (n=24) had higher serum IL-6 at inclusion and throughout the first 24 h (P<. 01) and higher urine IL-6 from 6 h after start of therapy (P<.01) than did nonbacteremic patients (n=57). The serum and urine IL-6 responses remained elevated longer in the bacteremic group. Patients with clinical signs of pyelonephritis had higher serum and urine IL-6 concentrations than did other patients in the study population (P=.058, P<.01, respectively). IL-6 high responders had higher temperatures (P<.05) and C-reactive protein levels (P<.05, P<.01) than did low responders. The results demonstrate that IL-6 responses accompany febrile UTIs regardless of bacteremia and that the response reflects disease severity. The results suggest that IL-6 produced in the urinary tract can trigger the systemic host response in the absence of bacteremia.
authors.affiliation: Department of Medical Microbiology, Division of Clinical Immunology, Lund University, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Otto
authors.forename: J
authors.initials: J
authors.lastname: Braconier
authors.forename: A
authors.initials: A
authors.lastname: Andreasson
authors.forename: C
authors.initials: C
authors.lastname: Svanborg
mesh_terms: D000210:Acute-Phase Reaction / Q000097:blood / Q000276:immunology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood* / Q000276:immunology*; D005260:Female; D005334:Fever / Q000097:blood / Q000276:immunology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood* / Q000652:urine; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000097:blood* / Q000276:immunology*
chemical_list: D015850:Interleukin-6