KNOWN BACTERIAL VIRULENCE FACTORS DO NOT EXPLAIN THE VARIATION IN URINARY CYTOKINE LEVELS IN PATIENTS WITH UROSEPSIS

We measured urinary endotoxin, IL-6 and IL-8 levels in 23 patients wit h gram-negative urosepsis. The endotoxin and cytokine levels showed a 100-1000 fold range. No correlation was found between levels of urinar y endotoxin, and IL-6 or IL-8 levels, In all cases bacterial numbers w ere greater than or equal to 10(5) CFU ml(-1) urine. The endotoxin con tent of the isolated microorganisms neither correlated with the urinar y cytokine levels, nor with IL-6 and IL-8 levels obtained in vitro whe n 10(3) log-phase CFU of each of the bacteria were incubated with hepa rinized whole blood of three healthy donors. Neither the haemolysin ph enotype of the bacteria, nor the presence of the P-pili gene was corre lated with the cytokine response in vivo or in vitro. Other factors th an known bacterial virulence factors apparently contribute to the wide variation in urinary cytokine levels in urinary tract infection.