Significance of urinary and serum IL -8 levels as indicator - tor for diagnosis of hositally acquired urinary tract infection

UTI is one of the main diseases affecting human beings especially when the infection is acquired inside hospital due to invasive medical procedures. Pyuria is one of the main features of U. T.I. The signs and symptoms may be nonsense and sometimes upper or lower UTI symptoms may not accompanied by pyuria. Nevertheless the mechanism of polymorph nuclear leucocytes [PNL] recruitment into the urine remain to be routinely investigated as an evidence for infection. Also the microbial urinary count more than 10[5] organism/ml urine coincide as an indicator for UTI. Although in many occasions it shows lower value or may be nil with eminent UTI. This study was done to detect level of interleukin-8 [IL-8] as potent neutrophil chemoattractant in cases of symptomatic and asymptomatic UTI. Urine and serum specimens were collected from three groups of patients with UTI: Group 1[20 patients with upper UTI], Group 11[20 patients with lower UTI], and Group III [20 patients with asymptomatic UTI] to compare between serum and urinary level of IL-8. A fourth group composed of ten apparently healthy normal controls with normal urine analysis and no bacteriuria were also included in the study. The study showed elevated mean levels of IL-8 in the urine of group 1[286. 9 pg/ml] and group 11[312 pg/ml] and group III [273.3 pg/ml] as compared to 8.9 pg/ml in controls. The mean urinary IL-8 levels were also raised more than the serum levels [96, 52, and 32 pg/ml in group I, II and III respectively] compared to 10.12 pg/ml in controls suggesting local production of IL-8 in the urinary tract mucosa which recruit into systemic circulation. The urinary IL-8 level was found to be correlated with the number of PNLs in the urine indicating exponential relation proving the role of IL-8 as chemoattractant. There was insignificant difference in mean urinary levels of IL-8 between upper or lower UTI, and also insignificant difference in serum IL-8 between both groups [P>0.05] although it was found to be higher in patients with upper UTI. In addition there was not any correlation between Gram -ve or Gram +ve isolated bacteria and variability of IL-8 level. Also, IL-8 level was not related to age or sex. The level of urinary IL-8 was raised in cases of UTI showing no symptoms or with oligopyuria and sometimes with microbial count less than 10[5] microorganism/ml urine. These results insure that IL-8 can be used as a sensitive indicator for all types of UTI either symptomatic or asymptomatic, with or without pyuria or significant bacterial count