Similar neutrophil-driven inflammatory and antibacterial responses in elderly patients with symptomatic and asymptomatic bacteriuria

Yanbao Yu, Martin D. Zielinski, Melanie A. Rolfe, Melissa M. Kuntz, Heidi Nelson, Karen E. Nelson, Rembert Pieper

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Differential diagnosis of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is based on the presence of diverse symptoms, including fever (>38.5°C), rigors, malaise, lethargy, flank pain, hematuria, suprapubic discomfort, dysuria, and urgent or frequent urination. There is consensus in the medical community that ASB warrants antibiotic treatment only for patients undergoing urological procedures that lead to mucosal bleeding, catheterized individuals whose ASB persists for more than 48 h after catheter removal, and pregnant women. Pyuria is associated with UTI and implicates host immune responses via release of antibacterial effectors and phagocytosis of pathogens by neutrophils. Such responses are not sufficiently described for ASB. Metaproteomic methods were used here to identify the pathogens and evaluate molecular evidence of distinct immune responses in cases of ASB compared to UTI in elderly patients who were hospitalized upon injury. Neutrophil-driven inflammatory responses to invading bacteria were not discernible in most patients diagnosed with ASB compared to those with UTI. In contrast, proteomic urine analysis for trauma patients with no evidence of bacteriuria, including those who suffered mucosal injuries via urethral catheterization, rarely showed evidence of neutrophil infiltration. The same enzymes contributing to the synthesis of leukotrienes LTB4 and LTC4, mediators of inflammation and pain, were found in the UTI and ASB cohorts. These data support the notion that the pathways mediating inflammation and pain in most elderly patients with ASB are not quantitatively different from those seen in most elderly patients with UTI and warrant larger clinical studies to assess whether a common antibiotic treatment strategy for elderly ASB and UTI patients is justified.

Original languageEnglish (US)
Pages (from-to)4142-4153
Number of pages12
JournalInfection and Immunity
Volume83
Issue number10
DOIs
StatePublished - 2015

Fingerprint

Bacteriuria
Neutrophils
Urinary Tract Infections
Wounds and Injuries
Pyuria
Urinary Catheterization
Anti-Bacterial Agents
Flank Pain
Dysuria
Pain
Inflammation Mediators
Leukotriene C4
Lethargy
Leukotriene B4
Neutrophil Infiltration
Urination
Leukotrienes
Hematuria
Phagocytosis
Proteomics

ASJC Scopus subject areas

  • Immunology
  • Microbiology
  • Parasitology
  • Infectious Diseases

Cite this

Similar neutrophil-driven inflammatory and antibacterial responses in elderly patients with symptomatic and asymptomatic bacteriuria. / Yu, Yanbao; Zielinski, Martin D.; Rolfe, Melanie A.; Kuntz, Melissa M.; Nelson, Heidi; Nelson, Karen E.; Pieper, Rembert.

In: Infection and Immunity, Vol. 83, No. 10, 2015, p. 4142-4153.

Research output: Contribution to journalArticle

Yu, Yanbao ; Zielinski, Martin D. ; Rolfe, Melanie A. ; Kuntz, Melissa M. ; Nelson, Heidi ; Nelson, Karen E. ; Pieper, Rembert. / Similar neutrophil-driven inflammatory and antibacterial responses in elderly patients with symptomatic and asymptomatic bacteriuria. In: Infection and Immunity. 2015 ; Vol. 83, No. 10. pp. 4142-4153.
@article{4176042dd33b4078adc252ef56602501,
title = "Similar neutrophil-driven inflammatory and antibacterial responses in elderly patients with symptomatic and asymptomatic bacteriuria",
abstract = "Differential diagnosis of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is based on the presence of diverse symptoms, including fever (>38.5°C), rigors, malaise, lethargy, flank pain, hematuria, suprapubic discomfort, dysuria, and urgent or frequent urination. There is consensus in the medical community that ASB warrants antibiotic treatment only for patients undergoing urological procedures that lead to mucosal bleeding, catheterized individuals whose ASB persists for more than 48 h after catheter removal, and pregnant women. Pyuria is associated with UTI and implicates host immune responses via release of antibacterial effectors and phagocytosis of pathogens by neutrophils. Such responses are not sufficiently described for ASB. Metaproteomic methods were used here to identify the pathogens and evaluate molecular evidence of distinct immune responses in cases of ASB compared to UTI in elderly patients who were hospitalized upon injury. Neutrophil-driven inflammatory responses to invading bacteria were not discernible in most patients diagnosed with ASB compared to those with UTI. In contrast, proteomic urine analysis for trauma patients with no evidence of bacteriuria, including those who suffered mucosal injuries via urethral catheterization, rarely showed evidence of neutrophil infiltration. The same enzymes contributing to the synthesis of leukotrienes LTB4 and LTC4, mediators of inflammation and pain, were found in the UTI and ASB cohorts. These data support the notion that the pathways mediating inflammation and pain in most elderly patients with ASB are not quantitatively different from those seen in most elderly patients with UTI and warrant larger clinical studies to assess whether a common antibiotic treatment strategy for elderly ASB and UTI patients is justified.",
author = "Yanbao Yu and Zielinski, {Martin D.} and Rolfe, {Melanie A.} and Kuntz, {Melissa M.} and Heidi Nelson and Nelson, {Karen E.} and Rembert Pieper",
year = "2015",
doi = "10.1128/IAI.00745-15",
language = "English (US)",
volume = "83",
pages = "4142--4153",
journal = "Infection and Immunity",
issn = "0019-9567",
publisher = "American Society for Microbiology",
number = "10",

}

TY - JOUR

T1 - Similar neutrophil-driven inflammatory and antibacterial responses in elderly patients with symptomatic and asymptomatic bacteriuria

AU - Yu, Yanbao

AU - Zielinski, Martin D.

AU - Rolfe, Melanie A.

AU - Kuntz, Melissa M.

AU - Nelson, Heidi

AU - Nelson, Karen E.

AU - Pieper, Rembert

PY - 2015

Y1 - 2015

N2 - Differential diagnosis of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is based on the presence of diverse symptoms, including fever (>38.5°C), rigors, malaise, lethargy, flank pain, hematuria, suprapubic discomfort, dysuria, and urgent or frequent urination. There is consensus in the medical community that ASB warrants antibiotic treatment only for patients undergoing urological procedures that lead to mucosal bleeding, catheterized individuals whose ASB persists for more than 48 h after catheter removal, and pregnant women. Pyuria is associated with UTI and implicates host immune responses via release of antibacterial effectors and phagocytosis of pathogens by neutrophils. Such responses are not sufficiently described for ASB. Metaproteomic methods were used here to identify the pathogens and evaluate molecular evidence of distinct immune responses in cases of ASB compared to UTI in elderly patients who were hospitalized upon injury. Neutrophil-driven inflammatory responses to invading bacteria were not discernible in most patients diagnosed with ASB compared to those with UTI. In contrast, proteomic urine analysis for trauma patients with no evidence of bacteriuria, including those who suffered mucosal injuries via urethral catheterization, rarely showed evidence of neutrophil infiltration. The same enzymes contributing to the synthesis of leukotrienes LTB4 and LTC4, mediators of inflammation and pain, were found in the UTI and ASB cohorts. These data support the notion that the pathways mediating inflammation and pain in most elderly patients with ASB are not quantitatively different from those seen in most elderly patients with UTI and warrant larger clinical studies to assess whether a common antibiotic treatment strategy for elderly ASB and UTI patients is justified.

AB - Differential diagnosis of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is based on the presence of diverse symptoms, including fever (>38.5°C), rigors, malaise, lethargy, flank pain, hematuria, suprapubic discomfort, dysuria, and urgent or frequent urination. There is consensus in the medical community that ASB warrants antibiotic treatment only for patients undergoing urological procedures that lead to mucosal bleeding, catheterized individuals whose ASB persists for more than 48 h after catheter removal, and pregnant women. Pyuria is associated with UTI and implicates host immune responses via release of antibacterial effectors and phagocytosis of pathogens by neutrophils. Such responses are not sufficiently described for ASB. Metaproteomic methods were used here to identify the pathogens and evaluate molecular evidence of distinct immune responses in cases of ASB compared to UTI in elderly patients who were hospitalized upon injury. Neutrophil-driven inflammatory responses to invading bacteria were not discernible in most patients diagnosed with ASB compared to those with UTI. In contrast, proteomic urine analysis for trauma patients with no evidence of bacteriuria, including those who suffered mucosal injuries via urethral catheterization, rarely showed evidence of neutrophil infiltration. The same enzymes contributing to the synthesis of leukotrienes LTB4 and LTC4, mediators of inflammation and pain, were found in the UTI and ASB cohorts. These data support the notion that the pathways mediating inflammation and pain in most elderly patients with ASB are not quantitatively different from those seen in most elderly patients with UTI and warrant larger clinical studies to assess whether a common antibiotic treatment strategy for elderly ASB and UTI patients is justified.

UR - http://www.scopus.com/inward/record.url?scp=84944472847&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84944472847&partnerID=8YFLogxK

U2 - 10.1128/IAI.00745-15

DO - 10.1128/IAI.00745-15

M3 - Article

C2 - 26238715

AN - SCOPUS:84944472847

VL - 83

SP - 4142

EP - 4153

JO - Infection and Immunity

JF - Infection and Immunity

SN - 0019-9567

IS - 10

ER -