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Distinguishing asymptomatic bacteriuria from urinary tract infection in the elderly - the use of urine levels of heparin-binding protein and interleukin-6

Kjölvmark, Charlott LU ; Tschernij, Emilia; Öberg, Jonas; Påhlman, Lisa I LU ; Linder, Adam LU and Åkesson, Per LU (2016) In Diagnostic Microbiology and Infectious Disease 85(2). p.243-248
Abstract

Asymptomatic bacteriuria (ABU) is highly prevalent among elderly patients. It can be difficult to distinguish ABU from symptomatic urinary tract infection (UTI) in this population, which leads to unnecessary antibiotic treatment. Urinary heparin-binding protein (U-HBP) and urinary interleukin-6 (U-IL-6) have previously been studied as diagnostic markers for UTI. In this study, biomarkers were measured in the urine of 134 nursing home residents. The prevalence of ABU in this population, excluding patients with urinary catheter, was 32.8%. Levels of U-HBP and IL-6 were significantly lower among residents with ABU when compared to 49 patients with verified UTI. When previously defined cut-off limits were used, U-HBP had a high negative... (More)

Asymptomatic bacteriuria (ABU) is highly prevalent among elderly patients. It can be difficult to distinguish ABU from symptomatic urinary tract infection (UTI) in this population, which leads to unnecessary antibiotic treatment. Urinary heparin-binding protein (U-HBP) and urinary interleukin-6 (U-IL-6) have previously been studied as diagnostic markers for UTI. In this study, biomarkers were measured in the urine of 134 nursing home residents. The prevalence of ABU in this population, excluding patients with urinary catheter, was 32.8%. Levels of U-HBP and IL-6 were significantly lower among residents with ABU when compared to 49 patients with verified UTI. When previously defined cut-off limits were used, U-HBP had a high negative predictive value for UTI (93%), however, the specificity for differentiating patients with UTI and ABU was low. Discriminatory values were better for U-IL-6 with a sensitivity of 80% and specificity of 82% for the differentiation between the subgroup of pyelonephritis and ABU.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diagnostic Microbiology and Infectious Disease
volume
85
issue
2
pages
243 - 248
publisher
Elsevier
external identifiers
  • Scopus:84962106973
  • WOS:000376822600026
ISSN
1879-0070
DOI
10.1016/j.diagmicrobio.2016.03.005
language
English
LU publication?
yes
id
142eb68e-708f-4330-9e0b-4eb0b9730884
date added to LUP
2016-04-27 13:05:08
date last changed
2017-01-01 08:23:49
@article{142eb68e-708f-4330-9e0b-4eb0b9730884,
  abstract     = {<p>Asymptomatic bacteriuria (ABU) is highly prevalent among elderly patients. It can be difficult to distinguish ABU from symptomatic urinary tract infection (UTI) in this population, which leads to unnecessary antibiotic treatment. Urinary heparin-binding protein (U-HBP) and urinary interleukin-6 (U-IL-6) have previously been studied as diagnostic markers for UTI. In this study, biomarkers were measured in the urine of 134 nursing home residents. The prevalence of ABU in this population, excluding patients with urinary catheter, was 32.8%. Levels of U-HBP and IL-6 were significantly lower among residents with ABU when compared to 49 patients with verified UTI. When previously defined cut-off limits were used, U-HBP had a high negative predictive value for UTI (93%), however, the specificity for differentiating patients with UTI and ABU was low. Discriminatory values were better for U-IL-6 with a sensitivity of 80% and specificity of 82% for the differentiation between the subgroup of pyelonephritis and ABU.</p>},
  author       = {Kjölvmark, Charlott and Tschernij, Emilia and Öberg, Jonas and Påhlman, Lisa I and Linder, Adam and Åkesson, Per},
  issn         = {1879-0070},
  language     = {eng},
  number       = {2},
  pages        = {243--248},
  publisher    = {Elsevier},
  series       = {Diagnostic Microbiology and Infectious Disease},
  title        = {Distinguishing asymptomatic bacteriuria from urinary tract infection in the elderly - the use of urine levels of heparin-binding protein and interleukin-6},
  url          = {http://dx.doi.org/10.1016/j.diagmicrobio.2016.03.005},
  volume       = {85},
  year         = {2016},
}