Host and Bacterial Markers that Differ in Children with Cystitis and Pyelonephritis - 23/05/19
, Judith M. Martin, MD 1, 2, Alejandro Hoberman, MD 1, 2, Megan Skae, RN 2, Linette Milkovich, RN 2, Andrew Nowalk, MD, PhD 1, 2, Christi McElheny, MS 3, Robert W. Hickey, MD 1, 2, Diana Kearney, ICRC 2, Massoud Majd, MD 4, Eglal Shalaby-Rana, MD 4, George Tseng, PhD 5, John F. Alcorn, PhD 2, Jay Kolls, MD 6, Marcia Kurs-Lasky, MS 1, Zhiguang Huo, PhD 7, William Horne, MS 2, Greg Lockhart, MD 8, Hans Pohl, MD 4, Timothy R. Shope, MD, MPH 1, 2Abstract |
Objective |
To determine whether treatment for urinary tract infections in children could be individualized using biomarkers for acute pyelonephritis.
Study design |
We enrolled 61 children with febrile urinary tract infections, collected blood and urine samples, and performed a renal scan within 2 weeks of diagnosis to identify those with pyelonephritis. Renal scans were interpreted centrally by 2 experts. We measured inflammatory proteins in blood and urine using LUMINEX or an enzyme-linked immunosorbent assay. We evaluated serum RNA expression using RNA sequencing in a subset of children. Finally, for children with Escherichia coli isolated from urine cultures, we performed a polymerase chain reaction for 4 previously identified virulence genes.
Results |
Urinary markers that best differentiated pyelonephritis from cystitis included chemokine (C-X-C motif) ligand (CXCL)1, CXCL9, CXCL12, C-C motif chemokine ligand 2, INF γ, and IL-15. Serum procalcitonin was the best serum marker for pyelonephritis. Genes in the interferon-γ pathway were upregulated in serum of children with pyelonephritis. The presence of E coli virulence genes did not correlate with pyelonephritis.
Conclusions |
Immune response to pyelonephritis and cystitis differs quantitatively and qualitatively; this may be useful in differentiating these 2 conditions.
Le texte complet de cet article est disponible en PDF.Keywords : prediction rule, risk, UTI, diagnostic accuracy, calculator
Abbreviations : APN, AUC, CCL, cDNA, CXCL, DE, DMSA, IFN, IL, NGAL, NK, UTI
Plan
| Funded by NIDDK (1R21 DK88672) Biomarkers for acute pyelonephritis. The authors declare no conflicts of interest. |
Vol 209
P. 146 - juin 2019 Retour au numéro
Article précédent
- High-Dose Vitamin D Supplementation Does Not Prevent Allergic Sensitization of Infants
- Jenni Rosendahl, Anna S. Pelkonen, Otto Helve, Helena Hauta-alus, Elisa Holmlund-Suila, Saara Valkama, Maria Enlund-Cerullo, Heli Viljakainen, Timo Hytinantti, Outi Mäkitie, Sture Andersson, Mika J. Mäkelä
- Classic Metaphyseal Lesions among Victims of Abuse
- Catherine Adamsbaum, Paul De Boissieu, Jean Paul Teglas, Caroline Rey-Salmon
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?