Accuracy of NGAL as a Biomarker for Urinary Tract Infection in Young Febrile Children: An Individual Patient Data Meta-Analysis - 05/07/23
, Tamar R. Lubell, MD 2, Peter S. Dayan, MD, MSc 2, Nader Shaikh, MD, MPH 1Abstract |
Objective |
To compare the accuracy of urine neutrophil gelatinase-associated lipocalin (NGAL) and leukocyte esterase (LE) for the diagnosis of urinary tract infection (UTI) in children.
Study design |
We performed a systematic review and individual patient data meta-analysis of studies that examined urine NGAL as a marker of UTI in children <18 years of age. We created a standardized definition of UTI and applied it to all included children. We compared sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) of NGAL with LE.
Results |
We included individual patient data from 3 studies for a total of 845 children. Included children had a mean age of 0.9 years (SD, 0.6 years). Using a cutoff of 32.7 ng/mL, NGAL had a sensitivity of 90.3% (95% CI: 83.2%-95.0%) and specificity of 93.7% (95% CI: 91.7%-95.4%) for the diagnosis of UTI. LE, using a cutoff of ≧ trace had a sensitivity of 81.1% (95% CI: 72.5%-87.9%) and specificity of 97.0% (95% CI: 95.4%-98.1%). The AUC for NGAL was 0.95 (95% CI: 0.92-0.98). The AUC for LE was 0.90 (95% CI: 0.86-0.93).
Conclusion |
In young, febrile children, urinary NGAL is more sensitive for the diagnosis of UTI than LE but is slightly less specific.
Le texte complet de cet article est disponible en PDF.Keywords : urinary tract infection, biomarkers, pediatric, screening, diagnostic accuracy
Abbreviations : AAP, AUC, CFU, E. coli, LE, NGAL, ROC, UTI
Plan
| The authors declare no conflicts of interest. |
Vol 258
Article 113394- juillet 2023 Retour au numéro
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