Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study

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dc.authoridDuzova, Ali/0000-0002-4365-2995
dc.authoridGedikbasi, Asuman/0000-0001-7121-6077
dc.authoridTekcan Karalı, Demet/0000-0001-7013-1354
dc.authoridTurkkan, Ozde Nisa/0000-0003-2928-9031
dc.authoridYURTSEVEN, ERAY/0000-0003-0565-6407
dc.authoridgüven, serçin/0000-0003-3284-9204
dc.authoridDursun, Hasan/0000-0002-8817-494X
dc.authorwosidDuzova, Ali/AAB-7692-2021
dc.authorwosidGedikbasi, Asuman/AAE-3613-2020
dc.authorwosidYel, Sibel/D-5275-2018
dc.authorwosidMontini, Giovanni/AGI-8385-2022
dc.authorwosidTekcan Karalı, Demet/D-5917-2017
dc.authorwosidTurkkan, Ozde Nisa/HGV-0948-2022
dc.authorwosidYURTSEVEN, ERAY/AAG-1851-2019
dc.contributor.authorYilmaz, Alev
dc.contributor.authorAfonso, Alberto Caldas
dc.contributor.authorAkil, Ipek
dc.contributor.authorAksu, Bagdagul
dc.contributor.authorAlpay, Harika
dc.contributor.authorAtmis, Bahriye
dc.contributor.authorAydog, Ozlem
dc.date.accessioned2024-08-04T20:52:10Z
dc.date.available2024-08-04T20:52:10Z
dc.date.issued2023
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground 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.en_US
dc.description.sponsorshipScientific Research Projects Coordination Unit of Istanbul University; European Society for Pediatric Nephrology (ESPN); Society for Children's Kidney Health; Istanbul Faculty of Medicine Foundationen_US
dc.description.sponsorshipUTILISE study was supported by Scientific Research Projects Coordination Unit of Istanbul University, by the European Society for Pediatric Nephrology (ESPN), by the Society for Children's Kidney Health, and by Istanbul Faculty of Medicine Foundation.en_US
dc.identifier.doi10.1007/s00467-022-05664-5
dc.identifier.endpage799en_US
dc.identifier.issn0931-041X
dc.identifier.issn1432-198X
dc.identifier.issue3en_US
dc.identifier.pmid35849222en_US
dc.identifier.scopus2-s2.0-85134507363en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage791en_US
dc.identifier.urihttps://doi.org/10.1007/s00467-022-05664-5
dc.identifier.urihttps://hdl.handle.net/11616/100793
dc.identifier.volume38en_US
dc.identifier.wosWOS:000826799500001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofPediatric Nephrologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectChildrenen_US
dc.subjectUrinary tract infectionen_US
dc.subjectUTIen_US
dc.subjectHeat shock proteinsen_US
dc.subjectHSP70en_US
dc.titleUrinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE studyen_US
dc.typeArticleen_US

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