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- Title
Biomarkers for febrile urinary tract infection in children.
- Authors
Shaikh, Nader; Liu, Hui; Kurs-Lasky, Marcia; Forster, Catherine S
- Abstract
Background: The sensitivity and specificity of the leukocyte esterase test for the diagnosis of urinary tract infection (UTI) are suboptimal. Recent studies have identified markers that appear to more accurately differentiate children with and without UTI. The objective of this study was to determine the accuracy of these markers, which included CCL3, IL-8, CXCL1, TNF-alpha, IL-6, IFN-gamma, IL-17, IL-9, IL-2, and NGAL, in the diagnosis of UTI. Methods: This was a prospective cross-sectional study to compare inflammatory proteins between urine samples from febrile children with a UTI, matched febrile controls without a UTI, and asymptomatic healthy controls. Results: We included 192 children (75 with febrile UTI, 69 febrile controls, and 48 asymptomatic healthy controls). Urinary proteins that best discriminated between febrile children with and without UTI were NGAL, a protein that exerts a local bacteriostatic role in the urinary tract through iron chelation; CCL3, a chemokine involved in leukocyte recruitment; and IL-8, a cytokine involved in neutrophil recruitment. Levels of these proteins were generally undetectable in asymptomatic healthy children. Conclusions: NGAL, CCL3, and IL-8 may be useful in the early diagnosis of UTI. Trial registration: ClinicalTrials.gov (NCT01391793)
- Subjects
URINARY tract infection diagnosis; DIAGNOSIS of fever; BIOMARKERS; INTERLEUKINS; KRUSKAL-Wallis Test; CROSS-sectional method; LEUCOCYTES; FISHER exact test; NEUTROPHILS; T-test (Statistics); TUMOR necrosis factors; CHI-squared test; DESCRIPTIVE statistics; CHEMOKINES; RECEIVER operating characteristic curves; LONGITUDINAL method; CHILDREN
- Publication
Pediatric Nephrology, 2022, Vol 37, Issue 1, p171
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-021-05173-x