ESPN 50th Annual Meeting

ESPN 2017


 
THE ROLE OF THE URINARY ANTIMICROBIAL PEPTIDE CATHELICIDIN LEVELS IN EARLY DIAGNOSIS OF URINARY TRACT INFECTION, DIFFERENTIATION OF CYSTITIS-PYELONEPHRITIS AND PREDICTION OF THE RESISTANT MICROORGANISMS
SERIM PUL 1 NURDAN YILDIZ 1 ALI YAMAN 2 TEVFIK BAYRAM 3 HARIKA ALPAY 1

1- MARMARA UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- MARMARA UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF BIOCHEMISTRY
3- MARMARA UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF PUBLIC HEALTH
 
Introduction:

Urinary tract infections(UTI) can lead to renal scarring resulting in hypertension and end-stage renal failure. Therefore,different markers such as antimicrobial peptide cathelicidin are studied for early diagnosis of UTI.

In this study, we investigated the role of urinary cathelicidin levels(UCL) in early diagnosis of UTI,differentiation of cystitis-pyelonephritis and prediction of the resistant microorganisms.

Material and methods:

109 patients(58 female, 23 male) with suspected UTI and 63 healthy children were included in the study.On admission,complete urine analysis and urine cultures of the patients were studied.Demographic data and associated renal diseases were recorded.Fifty eight patients were included in the cystitis subgroup,17 in the pyelonephritis and 34 in the sterile pyuria subgroup.UCL were measured in all patients and control group.

 

Results:

The median(IQR) age of patients was 84(72;1-216) months.UCL levels in the patient and and control groups were 14.99±5.43 and 15.18±4.52 ng/ml respectively,and no significant difference was present.There was no significant difference in UCL of the subgroups compared with each other and the control group(p>0.05).In cystitis subgroup,UCL in patients infected with E Coli(n=43) were significantly lower than in patients infected  with  microorganism  other than E.coli (n=11)(p=0.044).There was no significant relation between antibiotic resistance and UCL(p>0.05).Children with accompanying renal disease(n=8) in the sterile pyuria subgroup had significantly higher UCL than those without renal disease(n=26)(p=0.033).

Conclusions:

UCL in patients with suspected UTI is not useful in early and differential diagnosis of cystitis and pyelonephritis,and in prediction of antibiotic resistance.However,it may provide early recognition of  UTI with microorganisms other than E.coli and may help to  decide effective  early empirical treatment of these patients.High UCL in children with sterile pyuria and accompanying kidney disease in our study suggest that urinary cathelicidin may be protective against urinary tract infections in this group.