Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

Abstract

PurposeThe aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and β-2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever.MethodsA total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in this study. We compared uNGAL and uB2MG between the UTI and non-UTI groups at the time of admission. The sensitivity, specificity, accuracy, and area under the curve (AUC) of uNGAL and uB2MG for use in diagnosing UTI were assessed.ResultsAmong 422 patients, 102 (24.2%) were diagnosed with UTI. Levels of uNGAL were higher in the UTI group than in the non-UTI group (366.6 ng/mL vs. 26.9 ng/mL, P<0.001). Levels of uB2MG were not different between the 2 groups. Multivariate analysis revealed that uNGAL was an independent predictive factor for UTI (P=0.033). The sensitivity, specificity, and accuracy were 90.2%, 92.5%, and 91.9% for uNGAL, and 48.0%, 43.8%, and 44.8% for uB2MG, respectively. AUC of uNGAL was 0.942 and that of uB2MG was 0.407.ConclusionAccuracy of uNGAL in the diagnosis of UTI is high in febrile infants aged <3 months. uNGAL can help in the early diagnosis and treatment of UTI in infants.

Biomarkers in urinary tract infections – which ones are suitable for diagnostics and follow-up?

“…It has a far-reaching effect on immune processes and has a direct bacteriostatic effect by blocking the siderophores on the Gram-negative bacterial wall [ 12 ]. NGAL levels elevate after 12 hours of the infection and reach their peak within 3 days [ 13 ]. Its secretion shows a variation by age and gender, but differences are small, thus there is no need for standardization [ 14 ].…”

Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach

“…High CRP values are common findings in UTI; however, CRP is a nonspecific marker of inflammation related to the etiology [ 42 , 43 ]. CRP is an acute-phase reactant, a sensitive indicator of inflammation and one of the most commonly used biomarkers in current medical practice.…”

Diagnostic accuracy of urine neutrophil gelatinase-associated lipocalin and urine kidney injury molecule-1 as predictors of acute pyelonephritis in young children with febrile urinary tract infection

“…Since that time several clinical studies have been conducted for assessing the diagnostic value of NGAL and KIM-1 for predicting UTI and APN in children. Most of them have demonstrated usefulness of uNGAL for early diagnosis of UTI in children [2, 11, 12, 14, 18, 31], for differentiation of UTI from contamination and colonization [32, 33], and for monitoring of treatment response [6, 14, 34]. In our previous study (2018), we found that uNGAL had lower sensitivity and specificity than serum NGAL for diagnosing febrile UTI as well as that uNGAL was not useful for diagnosing non-febrile UTI [21].…”