Shaikh et al reported urine biomarkers that can help to identify true urinary tract infections. These reflect an increased inflammatory response. The authors are from the University of Pittsburgh.
Biomarker battery:
(1) IL-2 (units not given, presumably pg/mL)
(2) IL-9 (units not given, presumably pg/mL)
(3) IL-8 (units not given, presumably pg/mL)
(4) NGAL (neutrophil gelatinase-associated lipocalin), in ng/mL
IL-9
NGAL
IL-8
IL-2
True UTI
< 5.3
< 189
< 191
NA
2.5%
< 5.3
< 189
>= 191
NA
43%
< 5.3
>= 189
NA
NA
100%
>= 5.3
NA
NA
< 3.3
57%
5.3 to 7.2
NA
NA
>= 3.3
71%
>= 7.3
NA
NA
>= 3.3
100%
Performance:
• The area under the ROC curve is 0.94.
Comment:
• The paper states that the specificity of leukocyte esterase is 87%. This battery requires ordering of 4 much more expensive tests. Therefore, it may be reserved for situations where the clinical diagnosis is uncertain.
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