Are Plasma Neutrophil Gelatinase Associated Lipocalin Levels Diagnostic in Uncomplicated Urinary Tract Infections?

Abstract

Objectives: Acute uncomplicated lower urinary tract infections are among the most common causes for emergency department visits and empirical antibiotic prescriptions. The purpose of this study was to determine whether the serum levels of the neutrophil gelatinase associated lipocalin (NGAL) molecule were important in the diagnosis and follow-up of non-complicated lower urinary tract infections. Materials and Methods: This was a cross-sectional, prospective study conducted from September 15, 2013 to April 15, 2014 in an academic emergency department. Eighty patients were enrolled in the study group and 40 healthy subjects in the control group. The patients had acute uncomplicated lower urinary tract infections with pyuria detected in a complete urinary test. All of the patients had their leukocyte, neutrophil, C-reactive protein (CRP), erythrocyte sedimentation rate, and NGAL levels evaluated before and after the treatment, and correlation among these parameters were investigated. Results: In the study group, the plasma leukocyte, neutrophil, and CRP levels before the treatment were significantly higher compared to the aftertreatment period (p<0.001). There was no significant difference found between the before-treatment and after-treatment levels of serum NGAL (p=0.091). Conclusion: Measuring plasma leukocyte, neutrophil, and CRP levels can support the diagnosis for urinary tract infections. However, plasma NGAL levels are not useful parameters for diagnosing non-complicated lower urinary tract infections.

Keywords

• Biomarkers for Infection
• Neutrophil Gelatinase Associated Lipocalin
• Urinary Tract Infections

Plazma Nötrofil Jelatinaz İlişkili Lipocalin Düzeyleri Komplike Olmayan İdrar Yolu Enfeksiyonunda Tanısal mıdır?

Abstract

Amaç: Akut komplike olmayan alt üriner sistem enfeksiyonları acil servislerde sıklıkla karşılaşılan ve ampirik antibiyotik reçete edilen hastalıklardandır. Bu çalışmada nötrofil jelatinaz ilişkili lipokalin (NGAL) molekülünün serum düzeylerinin akut komplike olmayan idrar yolu enfeksiyonlarının tanı ve takibinde öneminin olup olmadığının ortaya konması amaçlandı. Gereç ve Yöntem: Bu çalışma prospektif kesitsel bir çalışma olup 15 Eylül 2013-15 Nisan 2014 tarihinde yapıldı. Bu çalışmaya akut komplike olmayan alt üriner sistem enfeksiyonu semptomları olan, tam idrar tetkikinde piyüri saptanan ve ampirik antibiyotik tedavisi acil serviste planlanan 18-65 yaş arası 80 hasta ve kontrol grubu olarak sağlıklı 40 kişi dahil edildi. Tüm hastalardan tedavi öncesinde ve sonrasında lökosit, nötrofil, C-reaktif protein (CRP), eritrosit sedimentasyon hızı ve NGAL ölçümü yapıldı ve aralarındaki korelasyon araştırıldı. Bulgular: Hasta grubunda, plazma lökosit, nötrofil ve CRP’ye ait tedavi öncesi değerlerin tedavi sonrası değerlerine oranla daha yüksek olduğu görüldü (p<0,001). Tedavi öncesinde ölçülen serum NGAL değeri ile tedavi sonrasında ölçülen serum NGAL değeri arasında anlamlı olarak bir fark bulunmadı (p=0,091). Sonuç: Plazma lökosit, nötrofil ve CRP değerlerinin ölçümü ile idrar yolu enfeksiyonunun tanısı desteklenebileceği gibi takiplerinin yapılması ile de hastalığın prognozu hakkında bilgi edinilebilir. Ancak plazma NGAL düzeyi komplike olmayan idrar yolu enfeksiyonunun tanısında kullanılabilecek bir parametre değildir.

Keywords

• Enfeksiyon Biyobelirteçleri
• Nötrofil Jelatinaz İlişkili Lipokalin
• İdrar Yolu Enfeksiyonu

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