Age is a significant risk factor for recurrent urinary tract (rUTI) infections, but the clinical picture is often confused in older patients who also present with asymptomatic bacteriuria (ASB). Yet, how bacteriuria establishes in such patients and the factors underpinning and/or driving symptomatic UTI episodes are still not understood. To explore this further a pilot study was completed in which 30 male and female community based older patients (mean age 75y) presenting clinically with ASB / rUTIs and 15 control volunteers (72y) were recruited and monitored for up to 6 months. During this period symptomatic UTI episodes were recorded and urines collected for urinary cytokine and uropathogenic Escherichia coli (UPEC) analyses. Eighty-six per cent of patients carried E. coli (102 ≥ 105 CFU/ml urine) at some point throughout the study and molecular typing identified 26 different E. coli strains in total. Analyses of urine samples for ten different cytokines identified substantial patient variability. However, when examined longitudinally the pro-inflammatory markers, IL-1 and IL-8, and the anti-inflammatory markers, IL-5 and IL-10, were significantly different in the patient urines compared to those of the controls (P < 0.0001). Furthermore, analysing the cytokine data of the rUTI susceptible cohort in relation to E. coli carriage, showed the mean IL-10 concentration to be significantly elevated (P = 0.04), in patients displaying E. coli numbers ≥105 CFU/ml. These pilot study data suggest that bacteriuria, characteristic of older rUTI patients, is associated with an immune homeostasis in the urinary tract involving the synthesis and activities of the pro and anti-inflammatory cytokines IL-1, IL-5, IL-8 and IL-10. Data also suggests a role for IL-10 in regulating bacterial persistence.

中文翻译：

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尿 IL-10 浓度升高与易患复发性尿路感染的老年患者的大肠杆菌持续存在相关

年龄是复发性尿路 (rUTI) 感染的一个重要危险因素，但在同时出现无症状菌尿 (ASB) 的老年患者中，临床表现常常令人困惑。然而，菌尿是如何在这些患者中形成的，以及支持和/或驱动有症状的 UTI 发作的因素仍不清楚。为了进一步探索这一点，完成了一项试点研究，其中招募了 30 名临床上患有 ASB/rUTI 的男性和女性社区老年患者（平均年龄 75 岁）和 15 名对照志愿者（72 岁），并对其进行长达 6 个月的监测。在此期间，记录有症状的 UTI 发作并收集尿液用于尿细胞因子和尿路致病性大肠杆菌 (UPEC) 分析。86% 的患者携带 E. 在整个研究过程中的某个时间点出现大肠杆菌（102 ≥ 105 CFU/ml 尿液），分子分型总共确定了 26 种不同的大肠杆菌菌株。对 10 种不同细胞因子的尿液样本的分析确定了患者的显着差异。然而，当纵向检查时，与对照组相比，患者尿液中的促炎标志物 IL-1 和 IL-8 以及抗炎标志物 IL-5 和 IL-10 存在显着差异（P < 0.0001)。此外，分析与大肠杆菌携带相关的 rUTI 易感人群的细胞因子数据显示，在显示大肠杆菌数量 ≥105 CFU/ml 的患者中，平均 IL-10 浓度显着升高 (P = 0.04)。这些初步研究数据表明，老年 rUTI 患者的特征是菌尿，与泌尿道中的免疫稳态有关，包括促炎和抗炎细胞因子 IL-1、IL-5、IL-8 和 IL-10 的合成和活性。数据还表明 IL-10 在调节细菌持久性中的作用。