Host Response in Women with Symptomatic Urinary Tract Infection

Abstract

The agreement between clinical signs and host response was analysed in 174 women with symptomatic urinary tract infection. C-reactive protein (CRP) confirmed the clinical diagnosis in that 94% of non-pregnant and 91% of pregnant women with acute pyelonephritis had serum levels≥30 mg/1, compared with only 5% of cystitis patients. There was a significant increase in the erythrocyte sedimentation rate (ESR) and reduction of the renal concentrating capacity in patients with acute pyelonephritis, although the overlap with the cystitis group was greater than for CRP. The transient decrease in urine osmolality was unrelated to age, as were CRP, ESR and the total white blood cell count. Pregnant women had higher ESR but lower CRP levels than non-pregnant women wall acute pyelonephritis. The renal concentrating capacity was more reduced in those infected with Escherichia coli expressing adhesins specifically recognizing GakAl→4Galβ-containing receptors on uroepithelial cells.