Elevated urine levels of heparin-binding protein in children with urinary tract infection
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Charlott Kjölvmark1, Per Akesson, Adam Linder
1Division of Infection Medicine, Hospital of Helsingborg, 221 85 Lund, Sweden.
Insights
Urinary tract infection (UTI) in children can be effectively diagnosed using neutrophil-derived heparin-binding protein (HBP) in urine. This marker shows high accuracy, aiding in timely management of pediatric UTIs.
Area of Science:
- Pediatric infectious diseases
- Biomarker discovery
- Diagnostic accuracy
Background:
- Urinary tract infections (UTIs) are common in children, necessitating efficient diagnostic methods to prevent complications.
- Neutrophil-derived heparin-binding protein (HBP) is explored as a potential urinary biomarker for pediatric UTIs.
- Comparison with existing diagnostic tools like dipstick analysis, IL-6, and bacterial culture is crucial.
Purpose of the Study:
- To evaluate the utility of urinary HBP (U-HBP) levels as a diagnostic marker for UTI in children.
- To compare the diagnostic performance of U-HBP with established UTI diagnostic methods.
Main Methods:
- A prospective study enrolled 78 children (0-18 years) presenting with fever and/or UTI symptoms.
- Urine samples were analyzed for bacterial culture, dipstick results, and concentrations of HBP and IL-6.
- U-HBP levels were measured and analyzed using receiver operating characteristic (ROC) curves.
Main Results:
- U-HBP demonstrated high sensitivity (93.3%) and specificity (90.3%) for UTI detection at a cut-off of 32 ng/mL.
- U-HBP showed superior specificity compared to urine white blood cell counts and IL-6 levels.
- U-HBP exhibited higher sensitivity than the urine nitrite test, and all culture-confirmed UTIs had elevated U-HBP.
Conclusions:
- Rapid U-HBP analysis is a promising tool for guiding the management of suspected pediatric UTIs.
- U-HBP offers a sensitive and specific biomarker for diagnosing UTIs in children.
- This finding supports the integration of U-HBP testing into pediatric UTI diagnostic algorithms.
Background:
Urinary tract infection (UTI) is a common infection diagnosis in children, and efficient diagnosis and treatment are important to avoid serious complications. In this study we investigated whether urinary levels of neutrophil-derived heparin-binding protein (HBP) can be used as a marker of UTI in children. These results were compared to those of dipstick analysis, interleukin-6 (IL-6) analysis in urine, and bacterial culturing.
Methods:
Seventy-eight children aged 0-18 years with fever and/or symptoms indicating UTI were enrolled in a prospective consecutive study. Urine samples were cultured and analyzed with dipstick, and concentrations of HBP and IL-6 were measured.
Results:
Fifteen patients were classified as having UTI, 30 patients had fever but were diagnosed with a non-urinary tract infection, and 33 patients had neither UTI nor fever. Using a urine HBP (U-HBP) cut-off level of 32 ng/mL, the sensitivity and specificity for detecting UTI were 93.3 and 90.3 %, respectively. Receiver operating characteristic curves demonstrated that U-HBP levels were a higher specificity indicator of UTI than urine white blood cell counts or urine IL-6 levels; they also showed a higher sensitivity than the results of the urine nitrite test. All patients with significant growth of clinically relevant bacteria had elevated U-HBP levels.
Conclusion:
The results indicate that rapid analysis of U-HBP can provide helpful guidance in the management of children with suspected UTI.
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