Procalcitonin and C-reactive protein in urinary tract infection diagnosis

Area of Science:

• Pediatric infectious diseases
• Biomarker analysis
• Diagnostic accuracy

Background:

• Urinary tract infections (UTIs) are common in children, with prognosis dependent on infection site.
• Clinical signs and standard tests often fail to distinguish upper UTIs (acute pyelonephritis) from lower UTIs.
• Accurate differentiation is crucial for appropriate treatment and improved patient outcomes.

Purpose of the Study:

• To evaluate the diagnostic utility of procalcitonin (PCT) and C-reactive protein (CRP) in differentiating upper and lower UTIs in children.
• To compare the sensitivity and specificity of PCT and CRP for diagnosing acute pyelonephritis.

Main Methods:

• Retrospective analysis of PCT and CRP levels in pediatric patients with confirmed upper or lower UTIs.
• Receiver operating characteristic (ROC) curve analysis to determine diagnostic performance.
• PCT measured via chemiluminescent immunoassay.

Main Results:

• PCT and CRP levels were significantly higher in children with acute pyelonephritis compared to lower UTIs.
• PCT levels correlated with the extent of renal involvement, unlike CRP.
• PCT achieved 90.47% sensitivity and 88% specificity for detecting pyelonephritis, outperforming CRP (85.71% sensitivity, 48% specificity).

Conclusions:

• Both PCT and CRP are valuable for differentiating pediatric UTIs.
• PCT exhibits superior sensitivity and specificity compared to CRP in identifying acute pyelonephritis.
• PCT levels offer additional prognostic information regarding the severity of renal involvement.