title: Lipopolysaccharide-binding protein: a potential marker of febrile urinary tract infection in childhood.
abstract: BACKGROUND
  Urinary tract infections (UTIs) are encountered frequently in children, and their early diagnosis and treatment are important. This study evaluates the diagnostic value of serum concentrations of lipopolysaccharide-binding protein (LBP), an acute-phase protein, in children with febrile UTI and compares it to those of the total white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6).
  
  
  METHODS
  The study population comprised 77 consecutive patients with a first-episode febrile UTI (33 boys) with a median age of 11 months [interquartile range (IQR), 5.5-33 months], 21 healthy controls (11 boys) with a median age of 10 months (IQR, 5-20.5 months) and 58 febrile controls with a fever due to other causes (28 boys) with a median age of 12.5 months (IQR, 7-30 months). LBP, IL-6, PCT, and CRP were measured for both patients and control groups.
  
  
  RESULTS
  The serum levels of LBP (p  <  0.001), CRP (p  <  0.001), PCT (p  =  0.001), IL-6 (p  =  0.002), ESR (p  =  0.020), and WBC (p  <  0.001) were higher in patients with febrile UTI than in the healthy and febrile control groups. The LPB cut-off value for best sensitivity and specificity in patients with febrile UTI was >43.23 mg/l. Furthermore, the area under the receiver operating characteristic curve was significantly greater for LBP than for CRP (p  =  0.014), PCT (p  <  0.001), ESR (p  <  0.001), WBC (p  =  0.002) and IL-6 (p  =  0.006).
  
  
  CONCLUSIONS
  The results of this study suggest that the serum LBP concentration constitutes a reliable biologic marker for the diagnosis of a febrile UTI in children.
authors: Department of Microbiology, Alexandoupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis 68100, Greece.
authors: Evanthia A
authors: EA
authors: Tsalkidou
authors: Emmanouel
authors: E
authors: Roilides
authors: Stefanos
authors: S
authors: Gardikis
authors: Gregory
authors: G
authors: Trypsianis
authors: Alexandros
authors: A
authors: Kortsaris
authors: Athanasios
authors: A
authors: Chatzimichael
authors: Ioannis
authors: I
authors: Tentes
mesh_terms: D000209:Acute-Phase Proteins; D000293:Adolescent; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins / Q000097:blood*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D012372:ROC Curve; D014552:Urinary Tract Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002097:C-Reactive Protein; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins; D018836:Inflammation Mediators; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D011498:Protein Precursors; D000099231:Lipopolysaccharide-Binding Protein; C000606589:CALCA protein, human; C508600:IL6 protein, human