BACKGROUND The specificity of the leukocyte esterase test (87%) is suboptimal. The objective of this study was to identify more specific screening tests that could reduce the number of children who unnecessarily receive antimicrobials to treat a presumed urinary tract infection (UTI). METHODS Prospective cross-sectional study to compare inflammatory proteins in blood and urine samples collected at the time of a presumptive diagnosis of UTI. We also evaluated serum RNA expression in a subset. RESULTS We enrolled 200 children; of these, 89 were later demonstrated not to have a UTI based on the results of the urine culture obtained. Urinary proteins that best discriminated between children with UTI and no UTI were involved in T cell response proliferation (IL-9, IL-2), chemoattractants (CXCL12, CXCL1, CXCL8), the cytokine/interferon pathway (IL-13, IL-2, INFγ), or involved in innate immunity (NGAL). The predictive power (as measured by the area under the curve) of a combination of four urinary markers (IL-2, IL-9, IL-8, and NGAL) was 0.94. Genes in the pathways related to inflammation were also upregulated in serum of children with UTI. CONCLUSIONS Urinary proteins involved in the inflammatory response may be useful in identifying children with false positive results with current screening tests for UTI; this may reduce unnecessary treatment.

中文翻译：

---

区分假阳性尿液分析和真正尿路感染的生物标志物。


背景 白细胞酯酶测试的特异性 (87%) 不是最佳的。本研究的目的是确定更具体的筛查测试，以减少不必要地接受抗菌药物治疗尿路感染 (UTI) 的儿童数量。方法 前瞻性横断面研究比较推定诊断尿路感染时收集的血液和尿液样本中的炎症蛋白。我们还评估了一个子集中的血清 RNA 表达。结果 我们招收了 200 名儿童；根据尿培养结果，其中 89 人后来被证明没有尿路感染。最能区分患有尿路感染和无尿路感染的儿童的尿液蛋白涉及 T 细胞反应增殖（IL-9、IL-2）、趋化剂（CXCL12、CXCL1、CXCL8）、细胞因子/干扰素途径（IL-13、IL-13）。 2、INFγ），或参与先天免疫（NGAL）。四种尿液标记物（IL-2、IL-9、IL-8 和 NGAL）组合的预测能力（通过曲线下面积测量）为 0.94。患有尿路感染的儿童血清中与炎症相关通路中的基因也上调。结论 参与炎症反应的尿液蛋白可能有助于识别当前尿路感染筛查试验中出现假阳性结果的儿童；这可能会减少不必要的治疗。