Ahmadikia Kazem, Kordbacheh Parivash, Shadpour Pejman, Nami Sanam, Sarrafnejad Abdolfattah, Mahmoodi Mahmood, Safara Mahin, Rokni Mohsen, Yarahmadi Mohammad, Mahmoudi Shahram, Khezri Mahdis, Zaini Farideh
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2018 Jan;12(1):33-39.
Candiduria is common in the hospitalized patients. This study aimed to quantify interleukin (IL)-17 and IL-22 levels in urine of candiduric patients.
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.
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.
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.
念珠菌尿在住院患者中很常见。本研究旨在量化念珠菌尿患者尿液中白细胞介素(IL)-17和IL-22的水平。
在哈希米·内贾德肾脏中心对住院患者进行了一项病例对照研究。34例患者的尿液样本中检测出念珠菌属(每毫升>103菌落形成单位且仅存在念珠菌属)。排除伴有其他感染的尿液样本。34例直接检查和培养均为阴性的患者作为对照。对冻干和未冻干的尿液测量白细胞介素-17和IL-22水平。比较两组相关细胞因子滴度,并研究细胞因子升高与念珠菌尿的关联。
大多数念珠菌尿患者来自重症监护病房和泌尿外科的女性患者。只有4例患者(11.7%)表现出发热和排尿困难。4例患者出现大量白细胞尿。光滑念珠菌是最常见的分离菌种(44%)。与非念珠菌尿对照组相比,念珠菌尿患者尿液中IL-17和IL-22水平显著升高。虽然IL-17水平升高与念珠菌尿显著相关(优势比,1.09;95%置信区间,1.003至1.17;P = 0.04),但IL-22水平升高与念珠菌尿无关。结果表明,冻干尿液样本可最大程度提高尿中细胞因子的检测能力。
我们的结果表明,直接检查、真菌尿培养以及检测尿液IL-17和IL-22水平是诊断念珠菌性尿路感染的有用工具。