Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

  • Jung, Nani (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Byun, Hye Jin (Department of Urology, Keimyung University School of Medicine) ;
  • Park, Jae Hyun (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kim, Joon Sik (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kim, Hae Won (Department of Nuclear Medicine, Keimyung University School of Medicine) ;
  • Ha, Ji Yong (Department of Urology, Keimyung University School of Medicine)
  • Received : 2017.07.31
  • Accepted : 2017.09.26
  • Published : 2018.01.15
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Abstract

Purpose: The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and ${\beta}-2$ 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.

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References

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