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Clinical Investigation pp 71–80Cite as

Neutrophil Gelatinase-Associated Lipocalin: A Biomarker for Early Diagnosis of Urinary Tract Infections in Infants

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Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 1047))

Abstract

Early diagnosis of urinary tract infection (UTI) is challenging in infants due to unspecific symptoms, difficulty in urine collection and possible contamination. The aim of this study was to assesses the usefulness of serum and urine neutrophil gelatinase-associated lipocalin (sNGAL and uNGAL, respectively) in the diagnosis of febrile and non-febrile UTI in infants. This prospective observational study enrolled 66 infants with the first episode of UTI and 18 healthy controls. At the time of enrollment, sNGAL, uNGAL, urinalysis, urine culture, white blood cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), and serum creatinine (sCr) were assessed. We found that, on average, both sNGAL and uNGAL levels were significantly higher in febrile UTI, compared to non-febrile UTI and controls. In turn, the mean sNGAL level, but not uNGAL, was significantly higher in the non-febrile UTI group compared to controls. sNGAL positively correlated with WBC, CRP, ESR and PCT, and uNGAL with CRP and leukocyturia. The receiver operating curves (ROC) demonstrate that the optimum cut-off of 76.2 ng/ml for sNGAL (sensitivity 92.9%, specificity 94.4%, and the area under the curve (AUC) of 0.98) and of 42.2 ng/ml for uNGAL (sensitivity 73.8%, specificity 72.2%, and AUC of 0.76) for diagnosing febrile UTI and 39.0 ng/ml for sNGAL (sensitivity 83.3%, specificity 55.6%, and AUC of 0.70) for diagnosing non-febrile UTI. In conclusion, serum NGAL is an excellent marker for the early diagnosis of febrile UTI, with sensitivity and specificity higher than those of urine NGAL. Diagnostic sensitivity of serum NGAL is smaller in non-febrile infants suffering from UTI, and urine NGAL is not useful for this purpose at all.

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Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

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Authors and Affiliations

  1. Department of Pediatrics and Nephrology, Warsaw Medical University, 63A Żwirki and Wigury Street, 02-091, Warsaw, Poland

    Grażyna Krzemień, Małgorzata Pańczyk-Tomaszewska, Dominika Adamczuk & Agnieszka Szmigielska

  2. Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, Warsaw, Poland

    Iwona Kotuła & Urszula Demkow

Authors
  1. Grażyna Krzemień
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  2. Małgorzata Pańczyk-Tomaszewska
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  3. Dominika Adamczuk
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  4. Iwona Kotuła
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  5. Urszula Demkow
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  6. Agnieszka Szmigielska
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Correspondence to Agnieszka Szmigielska .

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  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

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Krzemień, G., Pańczyk-Tomaszewska, M., Adamczuk, D., Kotuła, I., Demkow, U., Szmigielska, A. (2017). Neutrophil Gelatinase-Associated Lipocalin: A Biomarker for Early Diagnosis of Urinary Tract Infections in Infants. In: Pokorski, M. (eds) Clinical Investigation. Advances in Experimental Medicine and Biology(), vol 1047. Springer, Cham. https://doi.org/10.1007/5584_2017_107

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