دورية أكاديمية

Urinary tract infections in children: Testing a novel, noninvasive, point-of-care diagnostic marker

التفاصيل البيبلوغرافية
العنوان: Urinary tract infections in children: Testing a novel, noninvasive, point-of-care diagnostic marker
المؤلفون: Lubell, Tamar R., Barasch, Jonathan M., King, Benjamin, Ochs, Julie B., Fan, Weijia, Duong, Jimmy, Chitre, Manasi, Dayan, Peter S.
المصدر: Acad Emerg Med
سنة النشر: 2022
مصطلحات موضوعية: Article, envir, socio
الوصف: OBJECTIVES: 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). METHODS: This was a prospective study of febrile children 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. RESULTS: 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. CONCLUSIONS: 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.
نوع الوثيقة: text
اللغة: English
العلاقة: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199382Test/
الإتاحة: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199382Test/
حقوق: undefined
رقم الانضمام: edsbas.B5002EB6
قاعدة البيانات: BASE