title: Preliminary study on serum paraoxonase-1 status and chemokine (C-C motif) ligand 2 in hospitalized elderly patients with catheter-associated asymptomatic bacteriuria.
abstract: Urinary tract infections (UTI) are common among elderly patients in residential care facilities, as well as in the hospital setting. Identifying new biochemical markers of UTI is an active line of research since UTI management is resource intensive. Paraoxonase-1 (PON1) forms part of the patient's immune system, the response-to-injury and inflammation. Our study sought to evaluate alterations in inflammation-related paraoxonase-1 (PON1) and chemokine (C-C motif) ligand 2 (CCL2) in patients with an indwelling catheter to assess their potential usefulness as biomarkers of infection. Patients (n = 142) who had had the urinary catheter removed and 100 healthy volunteers were recruited. In all participants we measured serum PON1 activity, PON1 concentration, CCL2, procalcitonin and C-reactive protein (CRP). Results indicated that patients had higher CCL2, CRP and procalcitonin concentrations than the control group, and lower paraoxonase activity. There were no significant differences in PON1 concentrations. When comparing the diagnostic accuracy of CRP, procalcitonin, CCL2 and the PON1-related variables in discriminating between patients with and those without UTI, we found a considerable degree of overlap between groups, i.e., a low diagnostic accuracy. However, there were significant inverse logarithmic correlations between serum paraoxonase activity and the number of days the urinary catheter had been in situ. Our results suggest that measurement of these biochemical variables may be useful in investigating complications of long-term use of these devices and help to improve the economic and clinical investment required in the management of the often-associated infection.
authors.affiliation: Department of Internal Medicine, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Iftimie
authors.affiliation: Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García-Heredia
authors.affiliation: Laboratori de Referència Sud, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Av. Comerç 42, 43204, Reus, Catalonia, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Pujol
authors.affiliation: Laboratori de Referència Sud, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Av. Comerç 42, 43204, Reus, Catalonia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Ballester
authors.affiliation: Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain.|Laboratori de Referència Sud, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Av. Comerç 42, 43204, Reus, Catalonia, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Fort-Gallifa
authors.affiliation: Laboratori de Referència Sud, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Av. Comerç 42, 43204, Reus, Catalonia, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Simó
authors.affiliation: Department of Internal Medicine, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Joven
authors.affiliation: Department of Internal Medicine, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain. jcamps@grupsagessa.com.
authors.forename: J
authors.initials: J
authors.lastname: Camps
authors.affiliation: Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Castro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D043303:Aryldialkylphosphatase / Q000097:blood*; D058070:Asymptomatic Diseases; D001437:Bacteriuria / Q000175:diagnosis*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D055499:Catheter-Related Infections / Q000175:diagnosis*; D018932:Chemokine CCL2 / Q000097:blood*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D044967:Serum / Q000737:chemistry*; D014552:Urinary Tract Infections / Q000175:diagnosis*
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D002116:Calcitonin; D002097:C-Reactive Protein; D043303:Aryldialkylphosphatase; C468406:PON1 protein, human