Evaluation of inflammatory and renal-injury markers in women treated with antibiotics for acute pyelonephritis caused by Escherichia coli.
The evolution and the relationship between inflammatory and renal-injury markers in women with acute uncomplicated pyelonephritis under antimicrobial therapy were investigated in a prospective study. Markers were measured before and 6 and 24 h after the intravenous administration of 1 g of ceftriaxone. Before treatment, the median levels of all markers except the serum creatinine levels were high. Twenty-four hours after the onset of antibiotic treatment, the C-reactive protein (CRP) level continued to be high, while the serum interleukin-6 (IL-6) levels and the urine IL-6, IL-8, albumin, and immunoglobulin G (IgG) levels decreased significantly. In contrast, serum creatinine and tumor necrosis factor alpha levels and urine N-acetyl-beta-glucosaminidase, alpha1-microglobulin, and beta2-microglobulin levels did not change over time. There was a significant correlation between IL-6 and IL-8 levels and urine albumin and IgG levels (urine albumin and IgG levels are glomerular and urinary tract-injury markers) as well as between serum CRP levels and the levels of the tubular-injury markers. In women with acute pyelonephritis, appropriate antibiotic treatment rapidly decreases serum IL-6 levels and urine IL-6 and IL-8 levels, which correlate well with urine albumin and IgG levels.
Horcajada
Juan P
JP
Service of Infectious Diseases, Institut Clínic Infeccions i Immunologia, Hospital Clínic Universitari-IDIBAPS, Barcelona, Spain. jhorcaja@clinic.ub.es
Velasco
María
M
Filella
Xavier
X
Alvarez
Luisa
L
De Làzzari
Elisa
E
Marín
Jose Luis
JL
Collvinent
Blanca
B
Smithson
Alex
A
Martínez
Jose Antonio
JA
Noguero
Mariana
M
Vila
Jordi
J
Mensa
Josep
J
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002097:C-Reactive Protein / Q000032:analysis; D002443:Ceftriaxone / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000652:urine; D018836:Inflammation Mediators / Q000097:blood* / Q000652:urine; D015850:Interleukin-6 / Q000097:blood / Q000652:urine; D016209:Interleukin-8 / Q000652:urine; D007668:Kidney / Q000293:injuries; D008875:Middle Aged; D011446:Prospective Studies; D011704:Pyelonephritis / Q000188:drug therapy* / Q000503:physiopathology*
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D007074:Immunoglobulin G; D018836:Inflammation Mediators; D015850:Interleukin-6; D016209:Interleukin-8; D002443:Ceftriaxone; D002097:C-Reactive Protein