interleukin-8 and Bacteriuria

Neutrophil accumulation in the graft kidney is a feature of cellular rejection and bacterial infection. The cellular infiltration is mediated by the local production of chemoattractant factors. The aim of the study was to analyze levels of IL-8 in renal graft recipients during and after episodes of acute renal rejection and urinary tract infection (UTI). A total of 50 renal graft recipients, including 10 with acute graft rejection (Group I) and 20 with UTI (Group II) were studied. Urine and serum levels of IL-8 were determined in patients of Group I before and after 7 days of antirejection therapy and in patients of Group II before and after 2 weeks of antimicrobial therapy. Results were compared with group of 20 patients with stable renal function and a group of 25 healthy people. IL-8 was determined by ELISA technique. The level of IL-8 in urine (uIL-8) was elevated in patients with acute graft rejection and uIL-8 decreased after antirejection treatment (772 +/- 241 pg/mg cr. vs 140 +/- 50 pg/mg cr.; p < 0.01). In 13 patients UTI was asymptomatic and 6 patients had an acute pyelonephritis. The level of uIL-8 was elevated in all patients with UTI and decreased after antimicrobial therapy. Levels of uIL-8 during acute pyelonephritis were significantly higher (p < 0.01) than in patients with asymptomatic bacteriuria (2582 +/- 950 pg/mg cr. vs 804 +/- 225 pg/mg cr.) Urine levels of IL-8 were lower in patients infected by Gram-positive Cocci as compared to patients infected by Gram-negative organisms. Patients with higher concentrations of serum creatinine during UTI had high urine levels of IL-8. Serum levels of IL-8 in patients of Group I and Group II were comparable with patients with stable graft function although they were higher than in control group. Elevated urinary secretion of IL-8 in acute rejection and UTI suggests a role of IL-8-neutrophiles system in in the pathogenesis in both inflammatory complications after kidney transplantation. Urine level of IL-8 was correlated with clinical symptoms of UTI.

Topics: Adult; Aged; Bacterial Infections; Bacteriuria; Biomarkers; Creatinine; Female; Graft Rejection; Humans; Interleukin-8; Kidney Transplantation; Male; Middle Aged; Neutrophil Activation; Pyelonephritis; Urinary Tract Infections

Objective diagnosis of symptomatic urinary tract infections in patients prone to asymptomatic bacteriuria is compromised by local host responses that are already present and the positive urine culture. We investigated interleukin-6 as a biomarker for nonfebrile urinary tract infection severity and diagnostic thresholds for interleukin-6 and 8, and neutrophils to differentiate between asymptomatic bacteriuria and urinary tract infection.. Patients with residual urine and neurogenic bladders due to spinal lesions included in a long-term Escherichia coli 83972 asymptomatic bacteriuria inoculation trial were monitored for 2 years. Symptom scoring and urine sampling to estimate interleukin-6 and 8, and neutrophils were performed regularly monthly and at urinary tract infection episodes.. Patients were followed in the complete study for a mean of 19 months (range 10 to 27) and those with asymptomatic bacteriuria with E. coli 83972 were followed a mean of 11 months (range 4 to 19). A total of 37 nonfebrile urinary tract infection episodes with complete data on interleukin-6 and 8, neutrophils and symptom scoring were documented. Interleukin-6 was the only marker that persistently increased during urinary tract infection compared to asymptomatic bacteriuria in pooled and paired intra-individual comparisons (p <0.05). Interleukin-6 above the threshold (greater than 25 ng/l) correlated to more severe urinary tract infection symptoms (p <0.05). The sensitivity and specificity of all biomarkers were poor/moderate when differentiating asymptomatic bacteriuria vs all urinary tract infection episodes. However, in urinary tract infections with worse symptoms interleukin-6 and neutrophils demonstrated equal good/excellent outcomes.. Triggered interleukin-6 correlated to urinary tract infection symptom severity and demonstrated a promising differential diagnostic capacity to discriminate urinary tract infection from asymptomatic bacteriuria. Future studies should explore interleukin-6 as a biomarker of urinary tract infection severity and assess the treatment indication in nonfebrile urinary tract infections.

Topics: Bacteriuria; Biomarkers; Cohort Studies; Diagnosis, Differential; Escherichia coli; Humans; Interleukin-6; Interleukin-8; Leukocyte Count; Neutrophils; Sensitivity and Specificity; Severity of Illness Index; Symptom Assessment; Urinary Tract Infections

Urinary tract infections (UTIs) are frequently polymicrobial diseases mainly sustained by Escherichia coli in association with other opportunistic pathogens. Cystitis and pyelonephritis are usually accompanied by an inflammatory response, which includes neutrophil recruitment. Uropathogenic E. coli possess the ability to evade host defenses, modulating the innate immune response. The aim of this study was to determine whether particular E. coli strains correlate with polymicrobial bacteriuria and whether escape from the early host defenses and microbial synergy could lead to mixed UTIs. We evaluated 188 E. coli-positive urine samples and assessed the relationships among polymicrobism, neutrophil presence and several traits of E. coli isolates (virulence factors such as hlyA, fimA, papC and their relative products, i.e. hemolysin, type 1 and P fimbriae, and cnf1, their phylogenetic group) and their ability to suppress cytokine response in 5637 bladder epithelial cells. Escherichia coli susceptibility toward quinolones and fluoroquinolones, known to be linked to the pathogenicity of this species, was also considered. We found significant correlations among polymicrobial bacteriuria, absence of pyuria and quinolone/fluoroquinolone susceptibility of E. coli isolates and their enhanced capability to suppress interleukin-8 urothelial production when compared with the patterns induced by the resistant strains.

Topics: Aged; Anti-Bacterial Agents; Bacteriuria; Epithelial Cells; Escherichia coli; Escherichia coli Infections; Female; Humans; Interleukin-8; Male; Microbial Sensitivity Tests; Middle Aged; Opportunistic Infections; Quinolones; Tumor Cells, Cultured; Urinary Bladder; Urinary Tract Infections

The severity of urinary tract infection (UTI) reflects the quality and magnitude of the host response. While strong local and systemic innate immune activation occurs in patients with acute pyelonephritis, the response to asymptomatic bacteriuria (ABU) is low. The immune response repertoire in ABU has not been characterized, due to the inherent problem to distinguish bacterial differences from host-determined variation. In this study, we investigated the host response to ABU and genetic variants affecting innate immune signaling and UTI susceptibility. Patients were subjected to therapeutic urinary tract inoculation with E. coli 83972 to ensure that they were exposed to the same E. coli strain. The innate immune response repertoire was characterized in urine samples, collected from each patient before and after inoculation with bacteria or PBS, if during the placebo arm of the study. Long-term E. coli 83972 ABU was established in 23 participants, who were followed for up to twelve months and the innate immune response was quantified in 233 urine samples. Neutrophil numbers increased in all but two patients and in an extended urine cytokine/chemokine analysis (31 proteins), the chemoattractants IL-8 and GRO-α, RANTES, Eotaxin-1 and MCP-1, the T cell chemoattractant and antibacterial peptide IP-10, inflammatory regulators IL-1-α and sIL-1RA and the T lymphocyte/dendritic cell product sIL-2Rα were detected and variably increased, compared to sterile samples. IL-6, which is associated with symptomatic UTI, remained low and numerous specific immune mediators were not detected. The patients were also genotyped for UTI-associated IRF3 and TLR4 promoter polymorphisms. Patients with ABU associated TLR4 polymorphisms had low neutrophil numbers, IL-6, IP-10, MCP-1 and sIL-2Rα concentrations. Patients with the ABU-associated IRF3 genotype had lower neutrophils, IL-6 and MCP-1 responses than the remaining group. The results suggest that the host-specific, low immune response to ABU mainly includes innate immune mediators and that host genetics directly influence the magnitude of this response.

Topics: Adult; Aged; Bacteriuria; Chemokines; Escherichia coli; Female; Humans; Immunity, Innate; Interleukin-6; Interleukin-8; Leukocytes; Male; Middle Aged; Polymorphism, Genetic; Promoter Regions, Genetic; Proteome

Although several studies suggest that genetic factors are associated with human UTI susceptibility, the role of DNA variation in regulating early in vivo urine inflammatory responses has not been fully examined. We examined whether candidate gene polymorphisms were associated with altered urine inflammatory profiles in asymptomatic women with or without bacteriuria.. We conducted a cross-sectional analysis of asymptomatic bacteriuria (ASB) in 1,261 asymptomatic women ages 18-49 years originally enrolled as participants in a population-based case-control study of recurrent UTI and pyelonephritis. We genotyped polymorphisms in CXCR1, CXCR2, TLR1, TLR2, TLR4, TLR5, and TIRAP in women with and without ASB. We collected urine samples and measured levels of uropathogenic bacteria, neutrophils, and chemokines.. Polymorphism TLR2_G2258A, a variant associated with decreased lipopeptide-induced signaling, was associated with increased ASB risk (odds ratio 3.44, 95%CI; 1.65-7.17). Three CXCR1 polymorphisms were associated with ASB caused by gram-positive organisms. ASB was associated with urinary CXCL-8 levels, but not CXCL-5, CXCL-6, or sICAM-1 (P< or =0.0001). Urinary levels of CXCL-8 and CXCL-6, but not ICAM-1, were associated with higher neutrophil levels (P< or =0.0001). In addition, polymorphism CXCR1_G827C was associated with increased CXCL-8 levels in women with ASB (P = 0.004).. TLR2 and CXCR1 polymorphisms were associated with ASB and a CXCR1 variant was associated with urine CXCL-8 levels. These results suggest that genetic factors are associated with early in vivo human bladder immune responses prior to the development of symptomatic UTIs.

Topics: Adult; Bacteriuria; Chemokines; Demography; Female; Genetic Variation; Gram-Negative Bacteria; Humans; Immunity, Innate; Interleukin-8; Neutrophils; Polymorphism, Single Nucleotide; Receptors, Interleukin-8A; Receptors, Interleukin-8B; Toll-Like Receptor 2; Urinary Tract; Urine

Urinary tract infection (UTI) is one of the most common sources of infection in children under 5. Rapid diagnosis is a need to avoid complications of UTI. The goal of the present study was to evaluate the use of urinary interleukin 8 (IL8) as a rapid laboratory method for diagnosis of UTI. A total of 116 children were included in the study. They were complaining of different diseases with pyuria. In addition twenty healthy children were included as control subjects. Urine samples were subjected to full chemical, cytological and bacteriological examinations. In addition, urinary IL8 was measured. Patients showed significantly elevated urine IL-8 levels (80-820 pg/ml) compared to control subjects (6-10 pg/ml) (p < 0.0001). There was significant correlation between interleukin 8 level and white blood cells counts in urine (p = 0.039). The mean +/- SD of urinary IL-8 was significantly increased 165.8 +/- 115.1 in urine with bacterial growth (Staphylococcus species and Escherichia coli) p < 0.001 than in urine without growth. Urine with Escherichia coli (E. coli) growth had significantly higher IL 8 level than growth with other types of organisms. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value had higher level for IL8 compared to other parameters in urine examination i.e., nitrite, WBCs and RBCs (85.7%, 60%, 64%, 87%, 64% respectively). This study highlights that bacteriuria is associated with higher level of urinary interleukin 8 than pyuria without bacteriuria. Thus from this study we can conclude that IL8 can be used as rapid surrogate marker for rapid laboratory diagnosis of urosepsis.

Topics: Bacteria; Bacteriuria; Biomarkers; Child; Child, Preschool; Female; Humans; Interleukin-8; Leukocyte Count; Male; Sensitivity and Specificity; Urinalysis

To study the local host response in patients with colonic and ileal neobladders, with or without bacteriuria.. Twenty-three patients with colonic neobladders and 19 with ileal neobladders were included. Eleven radical prostatectomy patients and seven healthy male volunteers were used as controls. Six urine samples were obtained from all patients and controls over a six-month period. The samples were cultured semiquantitatively, and the number of neutrophils and concentrations of the inflammatory mediators interleukin 6 and 8 (IL-6, IL-8) in the urine were determined.. The prostatectomy patients and healthy volunteers had sterile urine, and concentrations of IL-6 and IL-8 were below the detection limit. Most (>70%) of the urine samples from patients with colonic and ileal neobladders showed anaerobic or aerobic bacterial growth, and uropathogens were identified in about 45% of the samples. The local host response was minimal or undetectable in the sterile urine samples. However, the host response was markedly induced by uropathogenic strains in the urine, but not by urinary carriage of nonpathogenic or anaerobic strains. IL-8, but not IL-6, was increased in colonic neobladders, which corresponds to the mucosal host responses in patients with intact lower urinary tracts and asymptomatic bacteriuria. In ileal neobladders, the IL-8 responses were higher, and levels of IL-6 were significantly increased.. Neobladders exhibit a significant local host response to colonization with bacterial uropathogens. This reaction is more pronounced and includes IL-6 activation in ileal neobladders than in colonic neobladders.

Topics: Aged; Antibiotic Prophylaxis; Bacteriuria; Case-Control Studies; Colon; Humans; Ileum; Interleukin-6; Interleukin-8; Male; Middle Aged; Mucous Membrane; Urinary Bladder

It has been reported that urinary interleukin-6 (IL-6) and IL-8 levels are decreased in adult diabetic women with asymptomatic bacteriuria (ASB) when compared with non-diabetic women with ASB. Such impaired cytokine excretion might play a role in the higher prevalence of ASB among diabetic subjects. The aim of this study was to examine the urinary IL profile in children and young adults with type 1 diabetes mellitus (T1DM) with and without ASB. Midstream clean voiding urine samples were collected and cultured from 133 patients with T1DM (age: 15.6 +/- 5.7 yr) and 178 controls (14.1 +/- 4.7 yr) for two consecutive days. ASB was diagnosed in the case of >or=10(5) bacteria/mL. The urinary IL-6 and IL-8 concentrations were determined, and the presence of leukocyturia was also recorded. The prevalence of ASB was 16.5% in diabetic subjects and 2.8% in controls (p = 0.001). There was no difference between the diabetic and the control groups in the prevalence of 'IL-6-uria' (21.9 vs. 18.0%; p = 0.41), but IL-8 was more frequently detectable in the diabetic group (47.4 vs. 27.5%; p = 0.001). In individuals with ASB, the IL-8 level was similar in the diabetic (median: 70.0 pg/mg creatinine) and control group (42.3 pg/mg creatinine; p = 0.8). Indeed, the IL-8 levels were higher in diabetic subjects with ASB as compared with those without it (70.0 vs. <3.1 pg/mg creatinine; p = 0.001), and there was a significant association between the urinary IL-8 concentration and the bacterial count (p = 0.001). Diabetic patients with leukocyturia had higher IL-8 concentration than those without it (20.9 vs. <3.1 pg/mg creatinine; p = 0.003). Weak significant correlation was found between urinary IL-8 and hemoglobin A1c (HbA1c) (r = 0.4; p = 0.002). The sensitivity and specificity of leukocyturia were 50 and 89.9% in the whole population and those of IL-8 were 74.1 and 67.5%, respectively. In diabetic patients, 36.4% of the bacteriuria were gram-negative and 63.6% gram-positive. Our results suggest that diabetic children with ASB mount an IL-8 response to pathogens, which is comparable to non-diabetic children with bacteriuria. Thus, early in the natural history of diabetes, there are no significant changes in the IL response of children with ASB, as previously reported in adults.

Topics: Adolescent; Adult; Bacteriuria; Case-Control Studies; Child; Child, Preschool; Diabetes Mellitus, Type 1; Female; Glycated Hemoglobin; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Interleukin-6; Interleukin-8; Leukocytosis; Male; Sensitivity and Specificity

The role of asymptomatic bacteriuria in kidney transplant recipients is unknown. There is no clear evidence of its effect on transplanted kidney.. We studied urine cytokines profile among kidney transplant recipients with bacteriuria found in screening examination. Urine cultures were collected in 269 patients with stable graft function and serum creatinine level <2 mg/dl, during their routine visits. Interleukin (IL)-6 and IL-8 levels were measured in urine samples from patients with asymptomatic bacteriuria, symptomatic urinary tract infection and patients without bacteriuria (control group). Changes in serum creatinine level in patients with asymptomatic bacteriuria and in the control group were observed during 12 months follow up.. Urinary tract infection (UTI) was diagnosed in five patients and asymptomatic bacteriuria in 22 patients. Urine IL-6 level was significantly higher in symptomatic UTI group (median 15.71 pg/mg) but there were no differences between group of patients with asymptomatic bacteriuria (3.92 pg/mg) and control group (2.54 pg/mg). Urine IL-8 level was higher in symptomatic UTI group (median 146.8 pg/mg) and was also significantly higher in asymptomatic bacteriuria group (33.49 pg/mg) in comparison to control group (2.97 pg/mg; P=0.0002). During 1-year follow up, incidence of UTI was higher in the asymptomatic bacteriuria group than in the control group but graft function was not different in both groups.. Elevated urine IL-8 level in kidney transplant patients with asymptomatic bacteriuria may reflect impaired immune response to bacterial infection and occult inflammatory process in urinary tract.

Topics: Adult; Bacteriuria; Cytokines; Female; Follow-Up Studies; Graft Survival; Humans; Interleukin-6; Interleukin-8; Kidney Transplantation; Male; Mass Screening; Middle Aged

To evaluate urinary interleukin-8 (IL-8), an inflammatory cytokine, as a screening method for detecting asymptomatic bacteriuria in pregnancy.. Clean-catch urine samples from 200 pregnant women undergoing screening for asymptomatic bacteriuria were evaluated by urine culture, urine dipstick analysis, and measurement of IL-8. Interleukin-8 levels were measured by a chemiluminescent immunoassay (Immulite IL-8, Diagnostic Products Corp., Los Angeles, CA), and a receiver operating characteristic curve was used to determine the optimal cutoff point. Asymptomatic bacteriuria was defined as at least 100,000 colony-forming units of a single organism per mL. Dipstick testing included nitrite assessment as positive or negative and leukocyte esterase as negative, trace, 1+, 2+, or 3+. Dipstick testing was considered positive if nitrite was positive or leukocyte esterase was trace or greater. Sensitivities, specificities, positive and negative predictive values were determined for urinary leukocyte esterase and nitrite and compared with those of IL-8. chi(2) and Mann-Whitney U tests were used for statistical analyses.. Twenty women were identified with asymptomatic bacteriuria by urine culture. The median urinary IL-8 levels for women with and without asymptomatic bacteriuria were 356 pg/mL and 125 pg/mL, respectively (P <.01, Mann-Whitney U test). Using an optimal cutoff point of 264 pg/mL, IL-8 had a sensitivity, specificity, positive and negative predictive value of 70%, 67%, 19%, and 95% for predicting asymptomatic bacteriuria. Urine dipstick analysis with either a positive leukocyte esterase or nitrite had a sensitivity, specificity, positive and negative predictive value of 45%, 62%, 12%, and 91%, respectively, for detecting asymptomatic bacteriuria. The differences between these testing methods were not statistically significant.. Urinary interleukin-8 is not an acceptable screening method for asymptomatic bacteriuria in pregnancy because it fails to detect 30% of women with this condition.

Topics: Adult; Bacteriuria; Carboxylic Ester Hydrolases; Escherichia coli; Female; Humans; Interleukin-8; Luminescent Measurements; Nitrites; Predictive Value of Tests; Pregnancy; Pregnancy Complications, Infectious; Sensitivity and Specificity

Neutrophil migration to infected mucosal sites involves a series of complex interactions with molecules in the lamina propria and at the epithelial barrier. Much attention has focussed on the vascular compartment and endothelial cells, but less is known about the molecular determinants of neutrophil behavior in the periphery. We have studied urinary tract infections (UTIs) to determine the events that initiate neutrophil recruitment and interactions of the recruited neutrophils with the mucosal barrier. Bacteria activate a chemokine response in uroepithelial cells, and the chemokine repertoire depends on the bacterial virulence factors and on the specific signaling pathways that they activate. In addition, epithelial chemokine receptor expression is enhanced. Interleukin (IL)-8 and CXCR1 direct neutrophil migration across the epithelial barrier into the lumen. Indeed, mIL-8Rh knockout mice showed impaired transepithelial neutrophil migration, with tissue accumulation of neutrophils, and these mice developed renal scarring. They had a defective antibacterial defense and developed acute pyelonephritis with bacteremia. Low CXCR1 expression was also detected in children with acute pyelonephritis. These results demonstrate that chemokines and chemokine receptors are essential to orchestrate a functional antimicrobial defense of the urinary tract mucosa. Mutational inactivation of the IL-8R caused both acute disease and chronic tissue damage.

Topics: Animals; Bacterial Adhesion; Bacteriuria; Chemotaxis, Leukocyte; Child; Disaccharides; Drosophila Proteins; Escherichia coli; Escherichia coli Infections; Fimbriae, Bacterial; Genetic Predisposition to Disease; Glycosphingolipids; Humans; Immunity, Innate; Interleukin-8; Macrophages; Membrane Glycoproteins; Mice; Mice, Inbred BALB C; Mice, Inbred C3H; Mice, Knockout; Mucous Membrane; Neutrophils; Pyelonephritis; Receptors, Cell Surface; Receptors, Chemokine; Receptors, Interleukin-8A; Recurrence; Toll-Like Receptors; Urinary Tract Infections; Urothelium; Virulence

The urines from 43 asymptomatic children with spina bifida were examined. Eighty-one percent were abnormal because of bacteriuria and pyuria (51%), bacteriuria alone (26%) or pyuria alone (5%). Interleukin-8 was elevated in 54% of the abnormal urines. The presence of pyuria and interleukin 8 suggests that the asymptomatic bacteriuria reflects low grade infection rather than colonization.

Topics: Adolescent; Adult; Bacteriuria; Child; Child, Preschool; Female; Humans; Infant; Interleukin-8; Male; Pyuria; Spinal Dysraphism; Urinalysis; Urinary Catheterization

To assess the implications of detection of interleukin 8 (IL-8) in urine.. IL-8 was measured by immunoassay in all 305 urine samples from children aged 0-18.4 years received by our microbiology laboratory during four weeks, with a retrospective structured case note audit for all those in whom IL-8, white cells, or bacteria were detected. Patients were divided into three groups: urinary tract infection (UTI), at least one sample with >/=5 leucocytes x 10(9)/l and >/=10(5) cultured bacteria/ml; possible UTI, at least one sample with >/=5 leucocytes x 10(9)/l or >/=10(5) cultured bacteria/ml but not both; UTI unlikely, sample(s) with <5 leucocytes x 10(9)/l and <10(5) cultured bacteria/ml. Medical records were sought for all in groups 1 (14/14 found) and 2 (18/21 found) and those in group 3 (41/59 found) in whose urine any leucocytes, cultured bacteria, or IL-8 were detected.. IL-8 was detected in 58/305 samples from 48/264 patients. IL-8 was detected in at least one urine sample from 13/14 patients with confirmed UTI (group 1); in 11/21 patients with possible UTI (group 2), of whom two were treated as UTI; and in 23/228 patients without UTI. Using a cut off of 200 pg/ml, urine IL-8 had a sensitivity of 93% and a specificity of 90% for diagnosing UTI.. Urine IL-8 is a sensitive test for UTI, but is poorly specific as it is also present in a variety of other infectious and inflammatory disorders.

Topics: Adolescent; Bacteriuria; Biomarkers; Child; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Female; Humans; Infant; Infant, Newborn; Interleukin-8; Leukocyte Count; Male; Predictive Value of Tests; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Urinary Tract Infections

Topics: Adolescent; Adult; Aged; Bacteriuria; Cells, Cultured; Cytokines; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Glycosuria; Humans; Interleukin-6; Interleukin-8; Leukocytes; Lipopolysaccharides; Lymphocytes; Middle Aged; Reference Values; Salmonella; Tumor Necrosis Factor-alpha; Urine

Urine and serum interleukin (IL)-6 and IL-8 responses were higher in children with febrile urinary tract infection (n = 61) than in those with asymptomatic bacteriuria (n = 39). By univariate analysis, cytokine levels were related to age, sex, reflux, renal scarring, urine leukocytes, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and bacterial properties (P fimbriae but not hemolysin). Multivariate modeling showed that urine IL-6 responses were higher in girls than boys, increased with age, and were positively associated with CRP, ESR, serum IL-6, and urine leukocyte counts. The urine IL-8 response was not influenced by age, but it was influenced by P fimbriae and was associated with ESR, CRP, urine leukocytes, and female sex. The results show that cytokine responses to urinary tract infection vary with the severity of infection and that cytokine activation is influenced by a variety of host and bacterial variables.

Topics: Bacteriuria; Child, Preschool; Female; Fever; Fimbriae, Bacterial; Humans; Infant; Interleukin-6; Interleukin-8; Male; Sex Factors; Urinary Tract Infections