title: Cytokines in urine in elderly subjects with acute cystitis and asymptomatic bacteriuria.
abstract: OBJECTIVE
  Searching for useful diagnostic tools to discriminate between asymptomatic bacteriuria (ASB) and acute cystitis, this study compared urinary levels of cytokines/chemokines and leukocyte esterase in three groups of elderly subjects; those with acute cystitis, those with ASB, and those without bacteriuria.
  
  
  METHODS
  Comparative laboratory.
  
  
  METHODS
  Primary care.
  
  
  METHODS
  A total of 16 patients with acute cystitis, 24 subjects with ASB, and 20 controls without bacteriuria, all of whom were aged 80 or over.
  
  
  METHODS
  Urinary levels of IL-1 beta, TNF-alpha, IL-12, IL-18, CXCL1 (GRO-alpha), CXCL8 (IL-8), CCL2 (MCP-1), IL-6, IL-10, and leukocyte esterase.
  
  
  RESULTS
  Urinary levels of CXCL1, CXCL8, and IL-6 were significantly higher in acute cystitis patients than in the ASB group. The sensitivities and specificities for CXCL8, IL-6, and leukocyte esterase to discriminate between acute cystitis and ASB were 63% (95% CI 36-84) and 96% (95% CI 77-100) (cut-off > 285 pg/mg creatinine), 81% (95% CI 54-95) and 96% (95% CI 77-100) (cut-off > 30 pg/mg creatinine), and 88% (95% CI 60-98) and 79% (95% CI 57-92) (cut-off > 2, on a scale of 0-4), respectively.
  
  
  CONCLUSIONS
  The results indicate that measurement of urinary cytokines, and also leukocyte esterase, when using a cut-off value > 2, could be useful in clinical practice to discriminate between symptomatic and asymptomatic urinary tract infections in the elderly. A combination of IL-6 and leukocyte esterase could be even more useful. This needs to be evaluated in prospective studies on the diagnosis and treatment of urinary tract infections in an elderly population.
authors.affiliation: Centre for Clinical Research, Dalarna, Sweden. nils.rodhe@ltdalarna.se
authors.forename: Nils
authors.initials: N
authors.lastname: Rodhe
authors.forename: Sture
authors.initials: S
authors.lastname: Löfgren
authors.forename: Jan
authors.initials: J
authors.lastname: Strindhall
authors.forename: Andreas
authors.initials: A
authors.lastname: Matussek
authors.forename: Sigvard
authors.initials: S
authors.lastname: Mölstad
mesh_terms: D000369:Aged, 80 and over; D001437:Bacteriuria / Q000175:diagnosis / Q000652:urine*; D002265:Carboxylic Ester Hydrolases / Q000652:urine*; D003404:Creatinine / Q000652:urine; D003556:Cystitis / Q000175:diagnosis / Q000652:urine*; D016207:Cytokines / Q000652:urine*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000652:urine; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D003404:Creatinine; C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases