Presepsin as a predictor of septic shock in patients with urinary tract infection

Abstract Background Recently, presepsin has been reported to be a useful biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients. However, few reports have evaluated its usefulness in patients with urinary tract infections (UTI). This study aimed to evaluate whether presepsin could be a valuable marker for detecting severe sepsis, and whether it could predict the therapeutic course in patients with UTI compared with markers already used: procalcitonin (PCT) and C-reactive protein (CRP). Methods From April 2014 to December 2016, a total of 50 patients with urinary tract infections admitted to Gunma university hospital were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC) count, causative agents of urinary-tract infections, and other data were evaluated on the enrollment, third, and fifth days. The patients were divided into two groups: with (n = 11) or without (n = 39) septic shock on the enrollment day, and with (n = 7) or without (n = 43) sepsis on the fifth day, respectively. Presepsin was evaluated as a biomarker for systemic inflammatory response syndrome (SIRS) or septic shock. Results Regarding the enrollment day, there was no significant difference of presepsin between the SIRS and non-SIRS groups (p = 0.276). The median value of presepsin (pg/mL) was significantly higher in the septic shock group (p < 0.001). Multivariate logistic regression analysis showed that presepsin (≥ 500 pg/ml) was an independent risk factor for septic shock (p = 0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) of 0.881 for presepsin (vs. 0.690, 0.583, and 0.527 for PCT, CRP and WBC, respectively). Regarding the 5th day after admission, the median presepsin value on the enrollment day was significantly higher in the SIRS groups than in the non-SIRS groups (p = 0.006). On the other hand, PCT (≥ 2 ng/ml) on the enrollment day was an independent risk factor for SIRS. ROC curve for diagnosing sepsis on the fifth day indicated an AUC of 0.837 for PCT (vs. 0.817, 0.811, and 0.802 for presepsin, CRP, and WBC, respectively). Conclusions This study showed that presepsin may be a good marker for diagnosing septic shock based on admission data in patients with UTI.

Download Full-text

Presepsin as a predictor of severe sepsis in urinary tract infection

10.21203/rs.3.rs-284985/v1 ◽

2021 ◽

Author(s):

Yoshitaka Sekine ◽

Kazuhiko Kotani ◽

Daisuke Oka ◽

Hiroshi Nakayama ◽

Yoshiyuki Miyazawa ◽

...

Keyword(s):

Septic Shock ◽

Risk Factor ◽

Severe Sepsis ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Roc Curve ◽

Independent Risk Factor ◽

Good Marker ◽

Significant Difference ◽

Tract Infections

Abstract Background Recently, presepsin is reported to be a biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients, but there are few reports about urinary-tract infections. The objective of this study is to evaluate whether presepsin is a recent marker for detecting severe sepsis, and whether it can predict the therapeutic course in UTI when compared with procalcitonin (PCT) and C-reactive protein (CRP), already used markers.Methods From April 2014 to December 2016, a total of 50 patients, who were admitted into Gunma university hospital with urinary-tract infections, were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC), causative diseases of urinary-tract infections and other data were evaluated at the enrollment, third and fifth days. The patients were divided into two groups; with (n=11) or without (n=39) septic shock at the enrollment day, and with (n=7) or without (n=43) sepsis at the fifth day, respectively. Presepsin was evaluated for systemic inflammatory response syndrome (SIRS) or septic shock. Results Concerning the enrollment day, there was no significant difference of presepsin between SIRS and non-SIRS groups (p=0.276). The median presepsin (pg/mL) was significantly higher in the septic shock group (p<0.001). Multivariate logistic regression analysis showed presepsin (≧ 500 pg/ml) was an independent risk factor associated with septic shock (p=0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) at 0.881 for presepsin (vs. 0.690, 0.583 and 0.527 for PCT, CRP and WBC, respectively). Concerning the 5th day after admission, the median presepsin of the enrollment day was significantly higher in SIRS groups than non-SIRS groups (p=0.006). On the other hand, PCT (≥ 2 ng/ml) of the enrollment day was an independent risk factor associated with SIRS. ROC curve for diagnosing sepsis at the fifth day indicated an AUC at 0.837 for PCT (vs. 0.817, 0.811 and 0.802 for presepsin, CRP and WBC, respectively).Conclusions This study shows that presepsin may be a good marker for diagnosis of severe patients who need vasopressor therapy at the data of admission, and PCT may be a good marker for predicting hard-to-treat cases in UTI.

Download Full-text

Vitamin D Deficiency Is an Independent Risk Factor for Urinary Tract Infections After Renal Transplants

Medicine ◽

10.1097/md.0000000000000594 ◽

2015 ◽

Vol 94 (9) ◽

pp. e594 ◽

Cited By ~ 17

Author(s):

Young Eun Kwon ◽

Hyunwook Kim ◽

Hyung Jung Oh ◽

Jung Tak Park ◽

Seung Hyeok Han ◽

...

Keyword(s):

Vitamin D ◽

Risk Factor ◽

Urinary Tract ◽

Vitamin D Deficiency ◽

Urinary Tract Infections ◽

Independent Risk Factor ◽

Renal Transplants ◽

Tract Infections

Download Full-text

FP867VITAMIN D DEFICIENCY IS AN INDEPENDENT RISK FACTOR FOR URINARY TRACT INFECTIONS AFTER RENAL TRANSPLANTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfv185.56 ◽

2015 ◽

Vol 30 (suppl_3) ◽

pp. iii367-iii367

Author(s):

In Mee Han ◽

Geun Woo Ryu ◽

Jong Hyun Jhee ◽

Hyung Woo Kim ◽

Sul A Lee ◽

...

Keyword(s):

Risk Factor ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Independent Risk Factor ◽

Renal Transplants ◽

Tract Infections

Download Full-text

Exploring risk factors for intraoperative aneurysm rupture during clipping

10.21203/rs.2.20216/v1 ◽

2020 ◽

Author(s):

Zhi Zhu ◽

Ningning Song ◽

Yoko Kato ◽

Xi Chen ◽

Weichao Jiang ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Independent Risk Factor ◽

Clinical Status ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

Aneurysm Rupture ◽

University Hospital ◽

Significant Difference ◽

Intraoperative Rupture

Abstract Objective To investigate risk factors for aneurysm rupture in intracranial aneurysm clipping (IAC). Methods Patients admitted for IAC from April 2010 to December 2017 in the Fujita Health University Hospital or the First Affiliated Hospital of Xiamen University were retrospectively reviewed. Clinical parameters were recorded and analyzed using univariate and multivariate analysis. The Hunt-Hess grade was used to assess the preoperative clinical status of patients. Modified Rankin Scale was applied to evaluate the prognosis of patients 6 months after surgery. Results Univariate analysis showed that the preoperative clinical status ( p = 0.015) and the preoperative aneurysm rupture ( p = 0.005) were significantly associated with intraoperative aneurysm rupture (IAR) during clipping. Multivariate logistic regression analysis showed that the preoperative aneurysm rupture was an independent risk factor of IAR ( p < 0.001, OR = 10.518). There was no significant difference in the prognosis between patients with and without IAR ( p > 0.05). No significant differences existed on aspects of incidences and time points of rupture in the operations conducted by experienced surgeons compared with that conducted by less-experienced surgeons ( p > 0.05). Conclusion Preoperative aneurysm rupture is the independent risk factor for aneurysm rupture during IAC. Intraoperative rupture, if treated properly in time, has no influence on the prognosis of patients receiving IAC. Less-experienced surgeons can also reduce the incidence rate of IAR by strictly controlling surgical indications.

Download Full-text

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.3.16 ◽

2018 ◽

pp. 100-108

Author(s):

Dinh Khanh Le ◽

Dinh Dam Le ◽

Khoa Hung Nguyen ◽

Xuan My Nguyen ◽

Minh Nhat Vo ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Clinical Manifestations ◽

University Hospital ◽

E Coli ◽

Positive Urine ◽

Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

Download Full-text

Oral D mannose in the prevention and treatment of recurrent urinary tract infections: A review

Urogynaecologia ◽

10.4081/uij.2021.239 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Daniele Porru ◽

Annalisa De Silvestri ◽

Edda Buffa ◽

Catherine Klersy ◽

Barbara Gardella ◽

...

Keyword(s):

Urinary Tract ◽

Antibiotic Prophylaxis ◽

Urinary Tract Infections ◽

Resistant Bacteria ◽

Control Groups ◽

Recurrent Utis ◽

Recurrent Urinary Tract Infections ◽

Long Term Treatment ◽

Significant Difference ◽

Tract Infections

The results of several studies reveal that antibiotics may promote treatment resistance by causing alterations in the intestinal flora. The development of a gut reservoir of resistant bacteria promotes the development of UTIs through autoinfection. This review aims to address clinical reliability, efficacy and safety of long-term treatment with oral D mannose for the prevention of Recurrent Urinary Tract Infections (RUTI) in females. A comprehensive MEDLINE, Embase, Scopus and Cochrane search was performed for English language reports published before December 2018 using the term “recurrent urinary tract infections and D mannose” was carried out. We searched Medline, Embase, Scopus and the Cochrane Register of Controlled Trials from January 2010 to December 2018. Eligible studies did not include non-oral therapy, local (vaginal) treatment in women with recurrent UTIs. We identified eligible original articles. A few limitations of the review are the heterogeneity of the available studies, their different rational and aim, the assumption of D mannose for prophylaxis or treatment of recurrent UTIs. Oral D mannose performs well in the prevention of UTIs recurrences, significant improvement of urinary symptoms was observed, the disease- free time was longer in the groups of patients under prophylaxis with D mannose in comparison with control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin (PAC) etc. The review has limitations, as the studies are heterogeneous, the meta-analysis requires classifications that can also be arbitrary. Furthermore, single-arm studies are not included. Some of the authors found this evidence inconclusive, which results as a limitation of the study. D mannose prolonged the recurrence-free interval of recurrent UTIs, thus reducing the prolonged or cyclical use of antibiotics, improving clinical symptoms, with a significant difference between treatment and control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin). However, most clinical trials used an association of different substances commingled with D mannose, dosages and regimens of D mannose were different. For this reason, the evidence of the efficacy of D mannose remains low.

Download Full-text