Increased urine interleukin-6 concentrations correlate with pyelonephriticchanges on Tc-99m-dimercaptosuccinic acid scans in neonates with urinary tract infections

Interleukin (IL)-6 and -8 are important inflammatory cytokines in bacterial infections, Their serum and urine concentrations were measured in 27 neona tes with urinary tract infection (UTI) at onset and the second week of ther apy, as well as in 23 control neonates, Escherichia coli was isolated in 89 % of cases. Tc-99m-dimercaptosuccinic acid (Tc-99m-DMSA) scans were perform ed between the 10th and 90th days after UTI and showed pyelonephritic chang es in 15 neonates (56%), Increased IL-6 and IL-8 concentrations were found in urine but not in serum within the first 24 h after presumptive diagnosis of UTI (P = .036 and .010, respectively), suggesting that the neonatal uri nary tract can respond to uropathogens by producing inflammatory cytokines. Urine concentrations of IL-6 correlated with findings of renal changes in Tc-99m-DMSA scans (P = .012) and thus may serve as a marker of renal parenc hymal outcome. All neonates exhibited undetectable urine cytokine levels du ring the second week of therapy.