Urinary tract infections in children: Testing a novel, noninvasive, point-of-care diagnostic marker.
Urinary tract infections in children: Testing a novel, noninvasive, point-of-care diagnostic marker.
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DOI：
10.1111/acem.14402
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发表时间：
2022-03
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影响因子：
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中科院分区：
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尿中性粒细胞明胶酶相关脂钙蛋白（uNGAL）在通过导尿获得尿路感染（uti）时似乎高度准确。我们的主要目的是确定配对导管和袋尿标本之间uNGAL水平的一致性。我们的第二个目的是比较定量uNGAL、试纸uNGAL（一种潜在的护理点检测）和尿液分析（UA）的诊断试验特征。这是一项对发热儿童< 24个月评估尿路感染的前瞻性研究。我们在先前确定的阈值39.1 ng/mL下评估了定量uNGAL，在其内置阈值bbb50 ng/mL下评估了试纸uNGAL，在白细胞酯酶（LE）的标准阈值下评估了UA。尿培养阳性定义为病原体浓度为10万cfu /mL。共纳入211例患者（10%为尿培养阳性）；116人将导管和袋装样本配对。在uNGAL定量临界值≥39.1 ng/mL时，导管标本和袋装标本的一致性为0.76(95%置信区间[CI] = 0.67 ~ 0.83)，在uNGAL量尺阈值> ~ 50 ng/mL时，一致性为0.77 （95% CI = 0.68 ~ 0.84）。导管取样的uNGAL接收器工作特征曲线下面积为0.96 (95% CI = 0.89至1.00)，而袋装取样的uNGAL接收器工作特征曲线下面积为0.93 （95% CI = 0.87至- 0.99）。在LE阈值≥1+(57.1%)时，导管标本定量和试纸uNGAL的敏感性（90.5%）高于UA。袋装样品uNGAL的定量和量尺特异性（均为73.8%）低于导管样品（分别为94.3%和95.3%），与UA相似。从袋装和导管取样的uNGAL显示出不充分的一致性，不能互换使用。袋装样品中uNGAL的低特异性表明采样技术会影响uNGAL水平。
Urinary neutrophil gelatinase-associated lipocalin (uNGAL) appears highly accurate to identify urinary tract infections (UTIs) when obtained via catheterization. Our primary aim was to determine the agreement in uNGAL levels between paired catheter and bag urine specimens. Our secondary aim was to compare the diagnostic test characteristics of quantitative uNGAL, dipstick uNGAL (a potential point-of-care test), and urinalysis (UA). This was a prospective study of febrile children < 24 months evaluated for UTIs. We evaluated quantitative uNGAL at a previously identified threshold of 39.1 ng/mL, dipstick uNGAL at its built-in threshold of >50 ng/mL, and UA at standard thresholds for leukocyte esterase (LE). A positive urine culture was defined as >100,000 CFUs/mL of a pathogen. A total of 211 patients were included (10% with positive urine cultures); 116 had paired catheterized and bagged samples. The agreement between catheterized and bagged samples at a quantitative uNGAL cutoff of ≥39.1 ng/mL was 0.76 (95% confidence interval [CI] = 0.67 to 0.83) and 0.77 (95% CI = 0.68 to 0.84) at a uNGAL dipstick threshold of >50 ng/mL. The area under the receiver operating characteristic curve for uNGAL from a catheterized sample was 0.96 (95% CI = 0.89 to 1.00) compared to 0.93 (95% CI = 0.87 to −0.99) from a bagged sample. The sensitivities of catheterized sample quantitative and dipstick uNGAL (90.5%) were higher than UA at a LE threshold of ≥1+ (57.1%). Bagged-sample uNGAL had lower quantitative and dipstick specificities (both 73.8%) than from catheterized samples (94.3% and 95.3% respectively), similar to UA. uNGAL from bagged and catheterized samples showed insufficient agreement to be used interchangeably. The low specificity of uNGAL from bagged samples suggests that sampling technique affects uNGAL levels.
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影响因子：
3.6
作者：
Parravicini E;Nemerofsky SL;Michelson KA;Huynh TK;Sise ME;Bateman DA;Lorenz JM;Barasch JM
通讯作者：
Barasch JM
影响因子：
8
作者：
Glissmeyer, Eric W.;Korgenski, E. Kent;Byington, Carrie L.
通讯作者：
Byington, Carrie L.
影响因子：
2.4
作者：
Ouellet-Pelletier, Julie;Guimont, Chantal;Gravel, Jocelyn
通讯作者：
Gravel, Jocelyn
影响因子：
3
作者：
Lee, Hahn-Ey;Kim, Do Kyun;Park, Kwanjin
通讯作者：
Park, Kwanjin
影响因子：
5.1
作者：
HOBERMAN, A;CHAO, HP;ELLIS, D
通讯作者：
ELLIS, D