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. 2018 Jan;61(1):24-29.
doi: 10.3345/kjp.2018.61.1.24. Epub 2018 Jan 22.

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

Nani Jung  1 , Hye Jin Byun  2 , Jae Hyun Park  1 , Joon Sik Kim  1 , Hae Won Kim  3 , Ji Yong Ha  2
Affiliations

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

Nani Jung et al. Korean J Pediatr. 2018 Jan.

Abstract

Purpose: The 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.

Methods: A 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.

Results: Among 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.

Conclusion: Accuracy 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.

Keywords: Biomarkers; Neutrophil gelatinase-associated lipocalin; Urinary tract infection.

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Conflict of interest statement

Conflict of interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Study flow diagram. UTI, urinary tract infection; uNGAL, urinary neutrophil gelatinase-associated lipocalin; uB2MG, urinary β-2 microglobulin.
Fig. 2
Fig. 2. Receiver operating characteristic curve analysis of biomarkers in diagnosis of urinary tract infection. CRP, C-reactive protein; uNGAL, urinary neutrophil gelatinase-associated lipocalin.
See this image and copyright information in PMC

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