Dataset Information

What is the Diagnostic Accuracy of Novel Urine Biomarkers for Urinary Tract Infection?

ABSTRACT:

Background

Urinary tract infection (UTI) affects half of women at least once in their lifetime. Current diagnosis involves urinary dipstick and urine culture, yet both methods have modest diagnostic accuracy, and cannot support decision-making in patient populations with high prevalence of asymptomatic bacteriuria, such as older adults. Detecting biomarkers of host response in the urine of hosts has the potential to improve diagnosis.

Objectives

To synthesise the evidence of the diagnostic accuracy of novel biomarkers for UTI, and of their ability to differentiate UTI from asymptomatic bacteriuria.

Design

A systematic review.

Data sources and methods

We searched MEDLINE, EMBASE, CINAHL and Web of Science for studies of novel biomarkers for the diagnosis of UTI. We excluded studies assessing biomarkers included in urine dipsticks as these have been well described previously. We included studies of adult patients (≥16 years) with a suspected or confirmed urinary tract infection using microscopy and culture as the reference standard. We excluded studies using clinical signs and symptoms, or urine dipstick only as a reference standard. Quality appraisal was performed using QUADAS-2. We summarised our data using point estimates and data accuracy statistics.

Results

We included 37 studies on 4009 adults measuring 66 biomarkers. Study quality was limited by case-control design and study size; only 4 included studies had a prospective cohort design. IL-6 and IL-8 were the most studied biomarkers. We found plausible evidence to suggest that IL-8, IL-6, GRO-a, sTNF-1, sTNF-2 and MCR may benefit from more rigorous evaluation of their potential diagnostic value for UTI.

Conclusions

There is insufficient evidence to recommend the use of any novel biomarker for UTI diagnosis at present. Further evaluation of the more promising candidates, is needed before they can be recommended for clinical use.

SUBMITTER: Edwards G

PROVIDER: S-EPMC9902898 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

What is the Diagnostic Accuracy of Novel Urine Biomarkers for Urinary Tract Infection?

Edwards George G Seeley Anna A Carter Adam A Patrick Smith Maia M Cross Elizabeth LA E Hughes Kathryn K Van den Bruel Ann A Llewelyn Martin J MJ Verbakel Jan Y JY Hayward Gail G

Biomarker insights 20230123

<h4>Background</h4>Urinary tract infection (UTI) affects half of women at least once in their lifetime. Current diagnosis involves urinary dipstick and urine culture, yet both methods have modest diagnostic accuracy, and cannot support decision-making in patient populations with high prevalence of asymptomatic bacteriuria, such as older adults. Detecting biomarkers of host response in the urine of hosts has the potential to improve diagnosis.<h4>Objectives</h4>To synthesise the evidence of the d ...[more]

PMID: 36761839

Similar Datasets

Project description:BackgroundMidstream urine specimen cultures play an important role in assisting clinicians to choose antibiotics to remove urinary tract pathogens. At present, there are many culture methods for obtaining midstream urine specimens. In this article, different urine culture methods were compared to improve the detection rate of pathogenic bacteria in patients with urinary tract infections (UTIs).MethodsUrina sanguinis specimens were collected from 90 outpatients and inpatients who had UTI symptoms, had been clinically diagnosed with UTI between February and March 2021, and had been tested within 2 h using the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method. After incubation at 35 °C with 5% carbon dioxide (CO2) for 48 h, the detection rates of pathogenic bacteria in UTIs were compared among the three methods.ResultsA total of 75 strains of pathogenic bacteria were detected in the 90 specimens. The positive detection rates of pathogenic microorganisms were 23.33%, 73.33%, and 75.56% for the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method, respectively. Among the patients who used antibiotics before the collection of the urine specimens, the positive detection rates of pathogenic microorganism were 16.00%, 66.00% and 66.00% for the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method, respectively. In the specimens grown aseptically using the conventional 1-µL culture method, a similar average number of colonies was found using the modified 100-µL culture method and the centrifugal urine sediment culture method. Among the specimens with bacterial growth in the conventional 1-µL culture method, the average colony numbers of the three methods were similar.ConclusionsThe modified 100-µL culture method and the centrifugal urine sediment culture method greatly improved the positive detection rates of pathogenic bacteria in patients with UTIs.

Dataset Information

What is the Diagnostic Accuracy of Novel Urine Biomarkers for Urinary Tract Infection?

Background

Objectives

Design

Data sources and methods

Results

Conclusions

Publications

What is the Diagnostic Accuracy of Novel Urine Biomarkers for Urinary Tract Infection?

Similar Datasets

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