Predictors of urinary tract infection in acute stroke patients

Li, Yaming; Xu, Jianhua; Zhao, Yanxin

doi:10.1097/md.0000000000020952

Cited by 13 publications

(10 citation statements)

References 106 publications

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“…However, an elevated PCT should be evaluated carefully by the clinicians, especially in fragile people, because its value accurately predicts the presence of bacteraemia and bacterial load [16] and seems correlated to disease severity [14,15], regardless of the origin of the primary infection. Finally, three studies showed low accuracy and neglectable PCT changes in lower UTIs [12,14,15]. Those results suggest a marginal role of PCT during lower UTIs and seem congruent with the idea that PCT increases significantly during bacteremia.…”

Section: Procalcitoninmentioning

confidence: 58%

“…UTIs induce a significant increase in serum IL-6, and its level could differentiate lower and upper UTIs. Unfortunately, only two small studies evaluated this aspect and in two different clinical settings [15,21] Urine IL-6 was explored by eleven small studies [11,12,15,[19][20][21][22][23][26][27][28], usually performed in the elderly. Not all studies suggested a significant increase in urine IL-6 during UTIs, and the studies were too heterogenous to obtain a univocal recommendation.…”

Section: Interleukin-6mentioning

confidence: 99%

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Asymptomatic Bacteriuria or Urinary Tract Infection? New and Old Biomarkers

Martino

Novara

2022

IJTM

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Urinary tract infections (UTIs) are among the most common infective disease in the adult population. UTI diagnosis is based essentially on the presence of lower urinary tract symptoms (e.g., dysuria, urgency, and frequency) and the evidence of bacteriuria (by dipstick testing and/or urine culture). UTI diagnosis is not always easy because symptoms can be vague, or patient basal conditions can interfere negatively with the diagnostic process, whereas urine culture is still ongoing. In those cases, the differential diagnosis among UTIs and asymptomatic bacteriuria (ABU) may be challenging, while the clinician has to decide whether to start an antibiotic treatment shortly. The purpose of the present review is to analyze the biomarkers that could help in UTI diagnosis. Some biomarkers, such as procalcitonin, interleukin-6, neutrophil gelatinase-associated lipocalin, chemokines, lactoferrin, and bone morphogenetic protein-2, seem promising in UTI diagnosis, while other biomarkers failed to show any utility. Whereas a single biomarker was not enough, a combination of biomarkers could have more chances to help in the diagnosis.

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Section: Procalcitoninmentioning

confidence: 58%

Section: Interleukin-6mentioning

confidence: 99%

Asymptomatic Bacteriuria or Urinary Tract Infection? New and Old Biomarkers

Martino

Novara

2022

IJTM

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“…The hemoglobin peptide library can produce different biological effects, which include antimicrobial hemoglobin-derived peptides. Then, the antimicrobial hemoglobin-derived peptides can produce antibacterial effects, thereby reducing inflammation caused by microbial infections ( 28 , 29 ). Therefore, the requirement for RBC infusion was also included in our nomogram as a risk factor for infection.…”

Section: Discussionmentioning

confidence: 99%

A simple nomogram for predicting infectious diseases in adult kidney transplantation recipients

Chen

Zhang

Zhuang

et al. 2022

Front. Public Health

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ObjectiveTo investigate the risk factors of infectious diseases in adult kidney transplantation recipients and to establish a simple and novel nomogram to guide the prophylactic antimicrobial therapy.MethodsPatients who received kidney transplantation between January 2018 and October 2021 were included in the study and were divided into a training and a testing set at a 1:1 ratio. Risk factors correlated to infectious diseases were selected using a Least Absolute Shrinkage and Selection Operator (LASSO) regression model. The prediction model was built by incorporating the variables selected by the LASSO model into a logistic regression equation. Calibration curves and receiver operating characteristic (ROC) curves were also applied to assess the model calibration and discrimination. A nomogram consisting of the selected factors was established to provide individualized risks of developing infections. Decision curve analysis (DCA) was adopted to estimate the net benefit and reduction in interventions for a range of clinically reasonable risk thresholds.ResultsIn all, 863 adult kidney recipients were included in the study, and 407 (47.16%) of them developed infectious diseases during the 3-year follow–up period. A total of 8 variables were selected using LASSO regression and were retained for subsequent model construction and infection prediction. The area under the curve (AUC) was 0.83 and 0.81 in the training and testing sets, with high F scores of 0.76 and 0.77, sensitivity of 0.76 and 0.81, and specificity of 0.88 and 0.74, respectively. A novel nomogram was developed based on 8 selected predictors (requirement for albumin infusion, requirement for red blood cell infusion, triglyceride, uric acid, creatinine, globulin, neutrophil percentage, and white blood cells). The net benefit indicated that the nomogram would reduce unnecessary interventions at a wide range of threshold probabilities in both sets.ConclusionsAdult kidney transplantation recipients are high-risk hosts for infectious diseases. The novel nomogram consisting of 8 factors reveals good predictive performance and may promote the reasonable antimicrobial prescription. More external validations are required to confirm its effectiveness for further clinical application.

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“…Six articles (8)(9)(10)(11)(12)14) examined whether patient age had an effect on HAP infection. There were 301 HAP cases and 809 non-HAP cases.…”

Section: Agementioning

confidence: 99%

“…Six articles (8)(9)(10)(11)(12)14) examined the effect of NIHSS score at admission on the occurrence of HAP. There were 301 HAP cases and 809 non-HAP cases.…”

Section: Nihss Scorementioning

confidence: 99%

Risk factors of stroke complicated with hospital-acquired pneumonia: a systematic review and meta-analysis of cohort studies

Guo¹,

Dou²,

Zhou³

2021

Ann Palliat Med

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Background: Hospital-acquired pneumonia (HAP) is a common type of nosocomial infection and a common complication experienced by stroke patients during hospitalization. HAP can aggravate patients' primary disease condition and lead to death. Clinically, a variety of factors may affect the occurrence of HAP in patients. In this study, we conducted a meta-analysis of the literature to investigate the risk factors of stroke with HAP for clinical reference. Methods:The PubMed, Medline, Embase and Cochrane Library databases were selected as the sources for the literature search. English-language publications were included. The articles related to stroke with HAP were published from January 2000 to January 2021. The articles were screened and their quality was evaluated using the Newcastle-Ottawa Scale. A meta-analysis was performed of the factors affecting the incidence of HAP using Revman 5.4 software.Results: Ultimately, 7 articles with a total of 1,172 patients were included in the meta-analysis. Of the 1,172 patients, 352 (30.03%) had an HAP infection. The results of the meta-analysis showed that patient age [mean difference (MD) =4.91, 95% confidence interval (CI): 3.90 to 5.93; P<0.00001], National Institutes of Health Stroke Scale (NIHSS) score (MD =3.84, 95% CI: 3.01 to 4.67; P<0.00001), and patient malnutrition [odds ratio (OR) =1.85, 95% CI: 1.13 to 3.04; P=0.02] were risk factors for the development of HAP, while gender, stroke history, smoking history, and comorbidities (diabetes, hypertension, coronary heart disease, and hyperlipidemia) were not risk factors for the development of HAP.Discussion: A total of 7 articles were included in this meta-analysis examining the influencing factors of HAP in stroke patients. The results showed that age, NIHSS score, and malnutrition were risk factors of HAP in stroke patients, while gender, stroke history, smoking history, and complications (diabetes, hypertension, coronary heart disease, and hyperlipidemia) were not influencing factors of HAP.

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Predictors of urinary tract infection in acute stroke patients

Cited by 13 publications

References 106 publications

Asymptomatic Bacteriuria or Urinary Tract Infection? New and Old Biomarkers

Asymptomatic Bacteriuria or Urinary Tract Infection? New and Old Biomarkers

A simple nomogram for predicting infectious diseases in adult kidney transplantation recipients

Risk factors of stroke complicated with hospital-acquired pneumonia: a systematic review and meta-analysis of cohort studies

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