Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/47359
Title: Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study [Article]
Authors: Yilmaz A.
Afonso A.C.
Akil I.
Aksu B.
Alpay H.
Atmis B.
Aydog O.
Yüksel, Selçuk
Bayram, Meral Torun
Bilge, Ilmay
Bulut, Ipek Kaplan
Buyukkaragoz, Bahar
Comak, Elif
Demir, Belde Kasap
Dincel, Nida
Donmez, Osman
Durmus, Mehmet Akif
Duzova, Ali
Ertan, Pelin
Gedikbasi, Asuman
Goknar, Nilufer
Guven, Sercin
Hacihamdioglu, Duygu
Jankauskiene, Augustina
Kalyoncu, Mukaddes
Kenan, Bahriye Uzun
Kucuk, Nuran
Kural, Bahar
Montini, Giovanni
Morello, William
Nayir, Ahmet
Obrycki, Lukasz
Omer, Beyhan
Ozdemir, Ebru Misirli
Ozkayin, Nese
Paripovic, Dusan
Pehlivanoglu, Cemile
Saygili, Seha
Schaefer, Susanne
Sonmez, Ferah
Tabel, Yilmaz
Tas, Nesrin
Tasdemir, Mehmet
Teixeira, Ana
Tekcan, Demet
Tulpar, Sebahat
Turkkan, Ozde Nisa
Uysal, Berfin
Uysalol, Metin
Vaiciuniene, Daiva
Yavuz, Sevgi
Yel, Sibel
Yildirim, Tarik
Yildirim, Zeynep Yuruk
Yildiz, Nurdan
Yurtseven, Eray
Topaloglu, Rezan
Schaefer, Franz
Bayazit, Aysun Karabay
Litwin, Mieczyslaw
Keywords: Children
Heat shock proteins
HSP70
Urinary tract infection
UTI
Publisher: Springer Science and Business Media Deutschland GmbH
Abstract: Background: The accuracy of conventional urinalysis in diagnosing urinary tract infection (UTI) in children is limited, leading to unnecessary antibiotic exposure in a large fraction of patients. Urinary heat shock protein 70 (uHSP70) is a novel marker of acute urinary tract inflammation. We explored the added value of uHSP70 in discriminating UTI from other infections and conditions confused with UTI. Methods: A total of 802 children from 37 pediatric centers in seven countries participated in the study. Patients diagnosed with UTI (n = 191), non-UTI infections (n = 178), contaminated urine samples (n = 50), asymptomatic bacteriuria (n = 26), and healthy controls (n = 75) were enrolled. Urine and serum levels of HSP70 were measured at presentation in all patients and after resolution of the infection in patients with confirmed UTI. Results: Urinary (u)HSP70 was selectively elevated in children with UTI as compared to all other conditions (p < 0.0001). uHSP70 predicted UTI with 89% sensitivity and 82% specificity (AUC = 0.934). Among the 265 patients with suspected UTI, the uHSP70 > 48 ng/mL criterion identified the 172 children with subsequently confirmed UTI with 90% sensitivity and 82% specificity (AUC = 0.862), exceeding the individual diagnostic accuracy of leukocyturia, nitrite, and leukocyte esterase positivity. uHSP70 had completely normalized by the end of antibiotic therapy in the UTI patients. Serum HSP70 was not predictive. Conclusions: Urine HSP70 is a novel non-invasive marker of UTI that improves the diagnostic accuracy of conventional urinalysis. We estimate that rapid urine HSP70 screening could spare empiric antibiotic administration in up to 80% of children with suspected UTI. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information [Figure not available: see fulltext.] © 2022, The Author(s), under exclusive licence to International Pediatric Nephrology Association.
URI: https://doi.org/10.1007/s00467-022-05664-5
https://hdl.handle.net/11499/47359
ISSN: 0931-041X
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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