Prognostic value of pro-adrenomedullin, procalcitonin and C-reactive protein in predicting outcome of febrile urinary tract infection

ABSTRACT Introduction: Urinary tract infection (UTI) is the most common serious bacterial infection in young infants. Signs and symptoms are often nonspecific. Objectives: To describe clinical, demographic and laboratory features of UTI in infants ≤ 3 months old. Methods: Cross-sectional study of infants ≤ 3 months old with UTI diagnosed in a pediatric emergency department, for the period 2010-2012. UTI was defined as ≥ 50,000 colony-forming units per milliliter of a single uropathogen isolated from bladder catheterization. Paired urinalysis and urine culture from group culture-positive and group culture-negative were used to determine the sensitivity and specificity of pyuria and nitrite tests in detecting UTI. Results: Of 519 urine cultures collected, UTI was diagnosed in 65 cases (prevalence: 12.5%); with male predominance (77%). The most common etiologies were Escherichia coli (56.9%), Klebsiella pneumoniae (18.5%) and Enterococcus faecalis (7.7%). Frequent clinical manifestations were fever (77.8%), irritability (41.4%) and vomiting (25.4%). The median temperature was 38.7°C. The sensitivity of the nitrite test was 30.8% (95%CI:19.9-43.4%), specificity of 100% (95%CI:99.2-100%). Pyuria ≥ 10,000/mL had a sensitivity of 87.7% (95%CI:77.2-94.5%), specificity of 74.9% (95%CI:70.6 -78.8%). The median peripheral white blood cell count was 13,150/mm3; C-reactive protein levels were normal in 30.5% of cases. Conclusions: The male: female ratio for urinary tract infection was 3.3:1. Non-Escherichia coli etiologies should be considered in empirical treatment. Fever was the main symptom. Positive nitrite is highly suggestive of UTI but has low sensitivity; whereas pyuria ≥ 10,000/mL revealed good sensitivity, but low specificity. Peripheral white blood cell count and C-reactive protein concentration have limited usefulness to suggest UTI.

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Performances of serum creatinine, C-reactive protein and white blood cell to predict urinary tract infection in febrile children younger than 24 months of age

Pediatric Emergency Medicine Journal ◽

10.22470/pemj.2020.00038 ◽

2020 ◽

Vol 7 (1) ◽

pp. 28-34

Author(s):

Hoo Seung Lee ◽

Young Ho Kwak ◽

Joong Wan Park ◽

Do Kyun Kim ◽

Se Uk Lee

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Blood Cell ◽

Serum Creatinine ◽

White Blood Cell ◽

C Reactive Protein ◽

Reactive Protein

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Procalcitonin and C-Reactive Protein in Umbilical Cord Blood as Markers for Early Suspicion of Infection in Newborns of Women with Prenatal Urinary Tract Infection

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-1509083739 ◽

2016 ◽

Vol 15 (09) ◽

pp. 37-39

Author(s):

Rafael Del Castilho Villalba ◽

Adriana Cersósimo ◽

Israel Figueiredo ◽

Adauto Dutra Moraes Barbosa

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

C Reactive Protein ◽

Reactive Protein

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Do Serum C-reactive Protein and Interleukin-6 Predict Kidney Scarring After Urinary Tract Infection?

The Indian Journal of Pediatrics ◽

10.1007/s12098-013-1045-4 ◽

2013 ◽

Vol 80 (12) ◽

pp. 1002-1006 ◽

Cited By ~ 2

Author(s):

Luis Miguel Rodríguez ◽

Belén Robles ◽

José Manuel Marugán ◽

Ángeles Suárez ◽

José María García Ruiz de Morales

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Interleukin 6 ◽

C Reactive Protein ◽

Reactive Protein ◽

Kidney Scarring

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C - reactive protein and urinary tract infection due to Gram-negative bacteria in a pediatric population at a tertiary hospital, Mwanza, Tanzania

African Health Sciences ◽

10.4314/ahs.v19i4.45 ◽

1970 ◽

Vol 19 (4) ◽

pp. 3217-3224

Author(s):

Martha F Mushi ◽

Vaileth G Alex ◽

Mwanaisha Seugendo ◽

Vitus Silago ◽

Stephen E Mshana

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Enteric Bacteria ◽

Gram Negative Bacteria ◽

C Reactive Protein ◽

Gram Negative ◽

Reactive Protein ◽

Significant Bacteriuria ◽

Tract Infections

Introduction: Gram-negative bacteria are the major cause of urinary tract infections (UTI) in children. There is limited data on UTI systemic response as measured using C-reactive protein (CRP). Here, we report the association of CRP and UTI among children attending the Bugando Medical Centre, Mwanza, Tanzania.Methods: A cross-sectional study was conducted between May and July 2017. Urine and blood were collected and processed within an hour of collection. Data were analyzed using STATA version 13.Results: Of 250 enrolled children, 76(30.4%) had significant bacteriuria with 56(22.4%, 95%CI; 11.5-33.3) having gram-negative bacteria infection. There was dual growth of gram-negative bacteria in 3 patients. Escherichia coli (32.2%, 19/59) was the most frequently pathogen detected. A total of 88/250(35.2%) children had positive CRP on qualitative assay. By multinomial logistic regression, positive CRP (RRR=4.02, 95%CI: 2.1-7.7, P<0.001) and age ≤ 2years (RRR=2.4, 95%CI: 1.23-4.73, P<0.01) significantly predicted the presence of significant bacteriuria due to gram-negative enteric bacteria. Conclusion: C-reactive protein was significantly positive among children with UTI due to gram-negative bacteria and those with fever. In children with age ≤ 2 years, positive CRP indicates UTI due to gram-negative enteric bacteria.Keywords: C - reactive protein, urinary tract infection, Gram-negative bacteria, Mwanza, Tanzania.

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Role of C-Reactive Protein levels in Differentiating Upper Urinary Tract Infection and Lower Urinary Tract Infection in Adults

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v8i2.49 ◽

2020 ◽

Vol 08 (02) ◽

Author(s):

Gorijavolu Mamatha ◽

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Upper Urinary Tract ◽

C Reactive Protein ◽

Lower Urinary Tract Infection ◽

Protein Levels ◽

Reactive Protein ◽

Lower Urinary

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Role of Leptin in Febrile Urinary Tract Infection

Archives of Pediatric Infectious Diseases ◽

10.5812/pedinfect.95394 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Abolfazl Mahyar ◽

Parviz Ayazi ◽

Behnor Hanafizadeh ◽

Banafsheh Arad ◽

Reza Dalirani ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

C Reactive Protein ◽

Febrile Urinary Tract Infection ◽

Serum Leptin ◽

Reactive Protein ◽

Erythrocyte Sedimentation ◽

Significant Difference ◽

Febrile Uti

Background: Leptin is a hormone that plays an important role in human health against infections. Some studies have reported that leptin acts as a reactant phase marker in some infectious diseases. The role of leptin in febrile urinary tract infection (UTI) has not been adequately evaluated. Objectives: This study was conducted to determine the role of serum leptin in febrile UTI in children. Methods: Thirty-nine febrile UTI patients were compared with 40 healthy children for the serum leptin level. Serum leptin was measured by the enzyme-linked immunosorbent assay method. The results were compared between the groups. Results: Median (IQR) of serum leptin in the case and control groups was 2 ng/mL and 0.6 ng/mL, respectively. A significant difference was observed between the groups in the serum leptin level (P = 0.001). No significant difference was observed between cystitis and acute pyelonephritis patients in the serum leptin level. The correlation analysis showed no significant association between the serum leptin level and acute-phase reactant markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) (r = -0.13 and P = 0.41; r = -0.15 and P = 0.36, respectively). Conclusions: The present study showed that although serum leptin increases in febrile UTI, this increase is not correlated with C-reactive protein and erythrocyte sedimentation rate. Also, this marker cannot discriminate between cystitis and acute pyelonephritis.

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