Increased Urine Interleukin-17 and Interleukin-22 Levels in Patients With Candidal Urinary Tract Infection

Iran J Kidney Dis. 2018 Jan;12(1):33-39.

Abstract

Introduction: Candiduria is common in the hospitalized patients. This study aimed to quantify interleukin (IL)-17 and IL-22 levels in urine of candiduric patients.

Materials and methods: A case-control study was conducted on inpatients at Hashemi Nejad Kidney Center. Thirty-four patients were identified with Candida species in their urine samples (> 103 colony-forming units per milliliter and presence of Candida species only). Urine samples with concomitant infections were excluded. Thirty-four patients with negative direct examination and culture were included as the control patients. Interleulin-17 and IL-22 levels were measured in the lyophilized and nonlyophilized urine. The relevant cytokine titers of the two groups were compared, and the association of cytokine elevation and candiduria was investigated.

Results: The majority of the candiduric patients were from the intensive care and urology units of women. Only 4 patients (11.7%) manifested fever and dysuria. Massive leukocyturia was observed in 4 patients. Candida glabrata was the most commonly isolated species (44%). Levels of the urine IL-17 and IL-22 were significantly elevated in the candiduric patients, when compared to the noncandiduric controls. While an increased IL-17 level was significantly associated with candiduria (odds ratio, 1.09; 95% confidence interval, 1.003 to 1.17; P = .04), an increased IL-22 level was not. The results showed that lyophilized urine samples maximized the detection power of urinary cytokines.

Conclusions: Our results indicated that direct examination, fungal urine culture, and investigation of urine IL-17 and IL-22 levels are useful tools for diagnosis of Candida urinary tract infection.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / urine
  • Candida / classification
  • Candida / isolation & purification*
  • Candidiasis / diagnosis
  • Candidiasis / microbiology
  • Candidiasis / urine*
  • Case-Control Studies
  • Chi-Square Distribution
  • Colony Count, Microbial
  • Female
  • Humans
  • Interleukin-17 / urine*
  • Interleukin-22
  • Interleukins / urine*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Up-Regulation
  • Urinalysis
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / urine*
  • Young Adult

Substances

  • Biomarkers
  • Interleukin-17
  • Interleukins