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ORIGINAL ARTICLE
Korean J Pediatr 2018 January;61(1) :24-29.
Published online 2018 January 15.       
Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection
Nani Jung1, Hye Jin Byun2, Jae Hyun Park1, Joon Sik Kim1, Hae Won Kim3, Ji Yong Ha2
1Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
2Department of Urology, Keimyung University School of Medicine, Daegu, Korea
3Department of Nuclear Medicine, Keimyung University School of Medicine, Daegu, Korea
Corresponding Author: Ji Yong Ha ,Tel: +82-53-250-7647, Fax: +82-53-250-7643, Email: uroha@dsmc.or.kr
Copyright © 2018 by The Korean Pediatric Society
ABSTRACT
Purpose: The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and -2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever.
Methods: A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in this study. We compared uNGAL and uB2MG between the UTI and non-UTI groups at the time of admission. The sensitivity, specificity, accuracy, and area under the curve (AUC) of uNGAL and uB2MG for use in diagnosing UTI were assessed.
Results: Among 422 patients, 102 (24.2%) were diagnosed with UTI. Levels of uNGAL were higher in the UTI group than in the non-UTI group (366.6 ng/mL vs. 26.9 ng/mL, P<0.001). Levels of uB2MG were not different between the 2 groups. Multivariate analysis revealed that uNGAL was an independent predictive factor for UTI (P=0.033). The sensitivity, specificity, and accuracy were 90.2%, 92.5%, and 91.9% for uNGAL, and 48.0%, 43.8%, and 44.8% for uB2MG, respectively. AUC of uNGAL was 0.942 and that of uB2MG was 0.407.
Conclusion: Accuracy of uNGAL in the diagnosis of UTI is high in febrile infants aged <3 months. uNGAL can help in the early diagnosis and treatment of UTI in infants.
Keywords: Urinary tract infection | Biomarkers | Neutrophil gelatinase-associated lipocalin
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