Predictive ability of NGAL in identifying urinary tract infection in children with neurogenic bladders

摘要

Background Distinguishing between urinary tract infection (UTI) and colonization (UTC) in patients with neurogenic bladders who require clean intermittent catheterization (CIC) is difficult. Urinary neutrophil gelatinase-associated lipocalin concentrations (uNGAL) are increased in UTIs. Our objective was to determine the predictive accuracy of uNGAL for UTI in CIC-dependent children. Methods Cross-sectional study of CIC-dependent patients from August, 2015 to November, 2016. UTI was defined as (1) growth of ≥?50,000?cfu/mL of a uropathogen, (2) >?10 urinary white blood cells/hpf, and (3) ≥?2 of the following: temperature >?38?°C, abdominal pain, back pain, worsened incontinence, pain with catheterization, or malodorous/cloudy urine. Positive urine cultures that did not meet these criteria were grouped as UTC, and negative cultures were grouped as no growth. Results Two hundred one patients were included (no growth?=?100, UTC?=?77, UTI?=?24). Median (interquartile range) uNGAL was higher in the UTI group (UTI 1361 (931, 2516)?μg/g creatinine, UTC 246 (106, 548)?μg/g creatinine, no growth 36 (11, 179)?μg/g creatinine, p ?