The following is a summary of “Plasma procalcitonin and urine interleukin-8, neutrophil gelatinase–associated lipocalin, and calprotectin in the diagnostic process of a urinary tract infection at the emergency department,” published in the December 2024 issue of Infectious Disease by Middelkoop et al.
Researchers conducted a retrospective study to examine the effectiveness of plasma procalcitonin and urine levels of interleukin-8 (IL-8), neutrophil gelatinase–associated lipocalin (NGAL), and calprotectin in diagnosing urinary tract infections (UTIs) at the emergency department (ED).
They compared the performance of biomarkers with routine diagnostic methods (urine dipstick, automated urinalysis) in adults presenting at the ED with suspected UTIs. Patients were categorized based on the presence of a urine catheter, leukopenia, or no such conditions (standard) and were analyzed separately.
The results showed a UTI was clinically diagnosed in 91 of 196 episodes (46.4%) (standard: 29/67 [43.2%]; catheter: 46/73 [63.0%]; leukopenia: 17/60 [28.3%]; 4 patients had both). Procalcitonin did not differentiate between UTI and non-UTI. Urinary biomarkers were higher in UTI episodes (median, µg/mmol creatinine: NGAL, 7.8 vs 46.3; IL-8, 6.1 vs 76.6; calprotectin, 23.9 vs 265.4), with elevated levels in all subgroups. Biomarker cut-off values for 90% sensitivity showed low specificity (range 20.8-64.9%) and moderate accuracy (58.6-75.4%). Biomarkers performed similarly to routine diagnostics, except in patients with leukopenia, who showed non significantly higher area under the curve values. All urinary biomarkers positively correlated with urine leukocyte count.
Investigators concluded the plasma procalcitonin was not effective in diagnosing UTIs, and the evaluated urine biomarkers (IL-8, NGAL, and calprotectin) offered limited diagnostic value beyond routine methods, with a minor potential benefit in patients with leukopenia and primarily reflected the presence of leukocytes in the urine.
Source:sciencedirect.com/science/article/pii/S120197122400328X
The post Diagnostic Value of Urinary Biomarkers in Suspected UTIs first appeared on Physician's Weekly.