title: Serum soluble urokinase-type plasminogen activator receptor as a biological marker of bacterial infection in adults: a systematic review and meta-analysis.
abstract: The serum concentration of soluble urokinase-type plasminogen activator receptor (suPAR) reflects immune activation. We performed a meta-analysis to evaluate the usefulness of suPAR for the diagnosis and prognosis of bacterial infections. PubMed, Embase and Cochrane Library databases were searched for studies reporting the detection of suPAR in adult patients with bacterial infections. Seventeen studies were selected from 671 studies. The pooled sensitivity and specificity of suPAR for diagnosing infection were 0.73 and 0.79, respectively, and the area under the summary receiver operating characteristic curve (AUC) was 0.82. Subgroup analyses revealed suPAR showed similar AUC values for diagnosing sepsis and bacteremia, but the AUC for differentiating sepsis from systemic inflammatory response syndrome (SIRS) was only 0.68. Elevated suPAR levels were significantly associated with a high risk of death, with a pooled risk ratio of 3.37 (95% confidence interval, 2.60-4.38). The pooled sensitivity and specificity for predicting mortality were 0.70 and 0.72, respectivfely, with an AUC of 0.77. Serum suPAR could be a biomarker for the diagnosis and prognosis of bacterial infection, but it is relatively ineffective for differentiating sepsis from SIRS. Further investigation is required to evaluate whether using of suPAR in combination with other biomarkers can improve diagnostic efficacy.
authors.affiliation: Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Ni
authors.affiliation: Department of Neurology, Chinese PLA 305 Hospital, Beijing 100017, China.
authors.forename: Yuliang
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Junchang
authors.initials: J
authors.lastname: Cui
authors.affiliation: Department of Neurology, Chinese PLA 305 Hospital, Beijing 100017, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Clinical Pharmacology, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Youning
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001424:Bacterial Infections / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D055293:Receptors, Urokinase Plasminogen Activator