title: Elevated urine levels of heparin-binding protein in children with urinary tract infection.
abstract: BACKGROUND
  Urinary tract infection (UTI) is a common infection diagnosis in children, and efficient diagnosis and treatment are important to avoid serious complications. In this study we investigated whether urinary levels of neutrophil-derived heparin-binding protein (HBP) can be used as a marker of UTI in children. These results were compared to those of dipstick analysis, interleukin-6 (IL-6) analysis in urine, and bacterial culturing.
  
  
  METHODS
  Seventy-eight children aged 0-18 years with fever and/or symptoms indicating UTI were enrolled in a prospective consecutive study. Urine samples were cultured and analyzed with dipstick, and concentrations of HBP and IL-6 were measured.
  
  
  RESULTS
  Fifteen patients were classified as having UTI, 30 patients had fever but were diagnosed with a non-urinary tract infection, and 33 patients had neither UTI nor fever. Using a urine HBP (U-HBP) cut-off level of 32 ng/mL, the sensitivity and specificity for detecting UTI were 93.3 and 90.3 %, respectively. Receiver operating characteristic curves demonstrated that U-HBP levels were a higher specificity indicator of UTI than urine white blood cell counts or urine IL-6 levels; they also showed a higher sensitivity than the results of the urine nitrite test. All patients with significant growth of clinically relevant bacteria had elevated U-HBP levels.
  
  
  CONCLUSIONS
  The results indicate that rapid analysis of U-HBP can provide helpful guidance in the management of children with suspected UTI.
authors.affiliation: Division of Infection Medicine, Hospital of Helsingborg, 221 85 Lund, Sweden.
authors.forename: Charlott
authors.initials: C
authors.lastname: Kjölvmark
authors.forename: Per
authors.initials: P
authors.lastname: Akesson
authors.forename: Adam
authors.initials: A
authors.lastname: Linder
mesh_terms: D000293:Adolescent; D023181:Antimicrobial Cationic Peptides / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D001798:Blood Proteins / Q000652:urine*; D002352:Carrier Proteins / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014552:Urinary Tract Infections / Q000652:urine*
chemical_list: C062991:AZU1 protein, human; D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D001798:Blood Proteins; D002352:Carrier Proteins