Interleukin-6 concentrations in the urine and dipstick analyses were related to bacteriuria but not symptoms in the elderly: a cross sectional study of 421 nursing home residents

BMC Geriatrics

Ronny Gunnarsson⁵  Mirjana Hahn-Zoric²  Bengt Andersson⁶  Lars Jonsson⁹  Nils Rodhe⁸  Sigvard Mölstad⁷  Peter Ulleryd³  Marie Elm⁴  Pär-Daniel Sundvall¹ 

[1] Sandared Primary Health Care Centre, Sandared, Sweden;Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska Academy at the University of Gothenburg, Guldhedsgatan 10A, SE-413 46 Gothenburg, Sweden;Department of Communicable Disease Control, Västra Götalandsregionen, SE-501 82 Borås, Sweden;Health Care Unit Borås Municipality, Våglängdsgatan 21 B, SE-507 41 Borås, Sweden;Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Box 100, SE-405 30 Gothenburg, Sweden;Department of Clinical Immunology, Sahlgrenska Academy at the University of Gothenburg, Guldhedsgatan 10A, SE-413 46 Gothenburg, Sweden;Department of Clinical Sciences, General Practice, Lund University, CRC, Hus 28, Plan 11, Jan Waldenströms Gata 35, SE-205 02 Malmö, Sweden;Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden;Bio Imaging and Laboratory Medicine Unit, Södra Älvsborg Hospital, SE-501 82 Borås, Sweden

关键词: Diagnostic tests;    Dipstick urinalysis;    Nursing homes;    Homes for the aged;    Bacteriuria;    Urinary tract infections;    Interleukin-6;   

Others  :  1090112
DOI  :  10.1186/1471-2318-14-88

 received in 2014-05-07, accepted in 2014-07-24,  发布年份 2014

【 摘 要 】

Background

Up to half the residents of nursing homes for the elderly have asymptomatic bacteriuria (ABU), which should not be treated with antibiotics. A complementary test to discriminate between symptomatic urinary tract infections (UTI) and ABU is needed, as diagnostic uncertainty is likely to generate significant antibiotic overtreatment. Previous studies indicate that Interleukin-6 (IL-6) in the urine might be suitable as such a test. The aim of this study was to investigate the association between laboratory findings of bacteriuria, IL-6 in the urine, dipstick urinalysis and newly onset symptoms among residents of nursing homes.

Methods

In this cross sectional study, voided urine specimens for culture, urine dipstick and IL-6 analyses were collected from all residents capable of providing a voided urine sample, regardless of the presence of symptoms. Urine specimens and symptom forms were provided from 421 residents of 22 nursing homes. The following new or increased nonspecific symptoms occurring during the previous month were registered; fatigue, restlessness, confusion, aggressiveness, loss of appetite, frequent falls and not being herself/himself, as well as symptoms from the urinary tract; dysuria, urinary urgency and frequency.

Results

Recent onset of nonspecific symptoms was common among elderly residents of nursing homes (85/421). Urine cultures were positive in 32% (135/421), Escherichia coli was by far the most common bacterial finding. Residents without nonspecific symptoms had positive urine cultures as often as those with nonspecific symptoms with a duration of up to one month. Residents with positive urine cultures had higher concentrations of IL-6 in the urine (p < 0.001). However, among residents with positive urine cultures there were no differences in IL-6 concentrations or dipstick findings between those with or without nonspecific symptoms.

Conclusions

Nonspecific symptoms among elderly residents of nursing homes are unlikely to be caused by bacteria in the urine. This study could not establish any clinical value of using dipstick urinalysis or IL-6 in the urine to verify if bacteriuria was linked to nonspecific symptoms.

【 授权许可】

   
2014 Sundvall et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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