Predictive ability of NGAL in identifying urinary tract infection in children with neurogenic bladders.

Background: Distinguishing between urinary tract infection (UTI) and colonization (UTC) in patients with neurogenic bladders who require clean intermittent catheterization (CIC) is difficult. Urinary neutrophil gelatinase-associated lipocalin concentrations (uNGAL) are increased in UTIs. Our objecti...

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Publicado en:Pediatric Nephrology Vol. 33; no. 8; pp. 1365 - 1375
Autores principales: Forster, Catherine S., Ma, Qing, Bennett, Michael, Shah, Samir S., Goldstein, Stuart L., Jackson, Elizabeth
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-018-3936-0
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        atl: Predictive ability of NGAL in identifying urinary tract infection in children with neurogenic bladders.
      aug:
        au:
          Forster, Catherine S.
          Ma, Qing
          Bennett, Michael
          Shah, Samir S.
          Goldstein, Stuart L.
          Jackson, Elizabeth
        affil: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, 45229, Cincinnati, OH, USA
      sug:
        subj:
          Urinary Tract Infections Diagnosis
          Bladder, Neurogenic Therapy
          Urinary Catheterization, Intermittent
          Neutrophils
          Peptide Hydrolases
          Carrier Proteins Urine
          Cross Sectional Studies
          Human
          ROC Curve
          Leukocytes
          Abdominal Pain
          Back Pain
          Urinary Incontinence
          Creatinine Blood
          Confidence Intervals
          Sensitivity and Specificity
          Child
          Child: 6-12 years
      ab: Background: Distinguishing between urinary tract infection (UTI) and colonization (UTC) in patients with neurogenic bladders who require clean intermittent catheterization (CIC) is difficult. Urinary neutrophil gelatinase-associated lipocalin concentrations (uNGAL) are increased in UTIs. Our objective was to determine the predictive accuracy of uNGAL for UTI in CIC-dependent children.Methods: Cross-sectional study of CIC-dependent patients from August, 2015 to November, 2016. UTI was defined as (1) growth of ≥ 50,000 cfu/mL of a uropathogen, (2) > 10 urinary white blood cells/hpf, and (3) ≥ 2 of the following: temperature > 38 °C, abdominal pain, back pain, worsened incontinence, pain with catheterization, or malodorous/cloudy urine. Positive urine cultures that did not meet these criteria were grouped as UTC, and negative cultures were grouped as no growth.Results: Two hundred one patients were included (no growth = 100, UTC = 77, UTI = 24). Median (interquartile range) uNGAL was higher in the UTI group (UTI 1361 (931, 2516) μg/g creatinine, UTC 246 (106, 548) μg/g creatinine, no growth 36 (11, 179) μg/g creatinine, p < 0.01 for all comparisons). The area under the ROC curve for uNGAL for UTI versus no UTI was 0.89, 95% CI (0.80-0.98).Conclusion: uNGAL is elevated in CIC-dependent children with UTI compared to those with negative cultures and those with UTC.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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