| Summary: | 碩士 === 中華醫事科技大學 === 生物科技研究所 === 99 === Urinary tract infections (UTI) are the most common bacterial infections in communities and hospitals, including kidney, ureter, bladder, urethra and prostate as well as other parts of the male by bacterial, fungal or viral invasions. But the main source of infection is bacteria.
UTI are divided into upper urinary tract infection and lower urinary tract infection. Due to the location of lesions and abnormality of urinary tract, the clinical manifestations of urinary tract infection, diagnosis, treatment and complications could all be different. Urinary tract infections can be divided into three categories as symptomatic urinary tract infection, asymptomatic bacteria of urinary tract infections and other infections of the urinary tract. If no immediate action is taken, even a urinary tract infection with mild symptoms might result in inflammation of the kidney and urinary tract infection. This might lead to kidney failure and death.
In the United States, UTI antibiotics for medical treatment costs more than 10 billion dollars each year, resulting in huge medical expenses. Diagnosis of urinary tract infection usually uses C-reactive protein (CRP) or white blood cell (WBC) as tests in traditional laboratories. Furthermore, microbial identification results take usually more than 24 hours. That may cause time delay in diagnosis and is possible to evolve into sepsis, or even result in inappropriate use of antibiotics. Therefore, the purpose of this study is to explore Procalciton (PCT) in early diagnosis of urinary tract infections and to compare PCT with the existing CRP, WBC and other detection methods in terms of disease severity and treatments in order to reduce inappropriate use of
antibiotics and medical expenses.
For this purpose, 60 patients (38 female, 22 male) were evaluated. 180 non-UTI patients (64 female, 116 male) made up the control group. Cut-off ranges of biomarkers must be chosen according to the specific clinical context and they should be used as a complementary tool, to reinforce the clinical diagnostic workup. Their diagnostic utilities were compared using Receiver operating characteristic (ROC) curves.ROC analysis showed that optimal discrimination in UTI could be performed at a cut-off point of 0.49 ng/ml for PCT (sensitivity 83.3 %; specificity 100% ; Positive Predictive Value 100%; Negative Predictive Value 94.7 %) 、19.3 mg/L for CRP (sensitivity 78.3 %; specificity 63.9%; Positive Predictive Value 42%; Negative Predictive Value 89.8%) and 9700 for WBC (sensitivity 73.3 %; specificity 53.9 %; Positive Predictive Value 34.6 %; Negative Predictive Value 85.8 %). The areas under the ROC curves (95% confidence interval) for PCT 、CRP and WBC were 0.926 (0.885-0.956) 、0.744 (0.684-0.798) and 0.648 (0.584-0.708), respectively,and showed a significant difference . This study showed that procalcitonin could be a good indicator of UTI .
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