Urine neutrophil gelatinase-associated lipocalin in girls with recurrent urinary tract infections
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ORIGINAL ARTICLE
Urine neutrophil gelatinase-associated lipocalin in girls with recurrent urinary tract infections Catherine S. Forster 1,2
&
Allison M. Loechtenfeldt 1 & Samir S. Shah 1 & Stuart Goldstein 1
Received: 13 February 2020 / Revised: 1 June 2020 / Accepted: 5 June 2020 # IPNA 2020
Abstract Background Children who experience more than one urinary tract infection (UTI) are at increased risk of kidney scarring due to their UTIs. Girls are at especially high risk for developing kidney scarring as a result of recurrent UTIs. Prior work suggested that neutrophil gelatinase-associated lipocalin (NGAL) may be lower in children with recurrent UTI compared with those without. The objective of this work was to compare urine NGAL concentrations in matched urine samples in girls with single and recurrent UTIs. Methods Girls less than 6 years of age who presented with signs and symptoms of a UTI were eligible for enrollment. Both acute, obtained from residual urine collected as part of their clinical evaluation, and follow-up urine samples, obtained after the completion of antibiotics when the patient was in their usual state of health, were collected from patients. Acute and followup urine NGAL concentrations were compared between girls with single and recurrent UTIs, as well as those with negative cultures who served as controls. Results Seventy girls were included in this study, 6 controls, 43 single UTIs, and 20 girls with recurrent UTIs. Patients in the control group had lower median acute NGAL concentrations than either those with single or recurrent UTI. There were no differences in either acute or follow-up urine NGAL concentrations between those with single and recurrent UTIs. Conclusion In this cohort of girls less than 6 years of age, there is no difference in urine NGAL concentrations between those with single and recurrent UTIs. Keywords Urinary tract infections . Girls . Biomarkers . NGAL
Introduction Urinary tract infections (UTIs) are one of the most common bacterial infections in children. Approximately 8% of children with an initial UTI will go on to develop recurrent infections [1], placing these children at increased risk for kidney scarring [2]. However, despite the identification factors that increase the risk of recurrent UTIs, such as vesicoureteral reflux (VUR) [3] and bowel and bladder dysfunction (BBD) [4], accurately predicting which children will experience a recurrent infection at the time of the initial UTI is difficult. Indeed, one study * Catherine S. Forster [email protected] 1
Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
2
Children’s National Health System, 111 Michigan Ave NW, Suite 4800M, Washington DC 20010, USA
examined the rate of recurrent UTI in children with BBD and found that in several subsets of patients (those without VUR and not on prophylaxis and those with VUR and on prophylaxis), BBD was not associated with risk of UTI or febrile UTI, while in children with VUR and not on prophylaxis, BBD was ass
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