Heparin - Binding Protein as an Immunological Marker in Children Urinary Tract Infection

Abstract

Background: Urinary tract infections (UTI) are revealed to be one of the most important causes of morbidity and mortality in the world. Its diagnosis is often difficult, mainly in children with unclear and vague symptoms. The rapid tests for diagnosis of UTI have insufficient significance, and there is a prerequisite for additional trustworthy investigative tests. Heparin-binding protein (HBP) secreted from human neutrophils, has been investigated in different bacterial diseases and its role in diagnosis and prognosis has be proven but, little is known about its diagnostic value in UTI. Methods: The study includes 90 children from Mansoura University Children Hospital diagnosed as UTI by urine culture and 50 children with negative urine cultures as a control group. Urinary HBP (U-HBP) is investigated as a diagnostic marker in UTI. Also, the levels of urinary white blood cells (U-WBC), urinary interleukin-6 (U IL-6) and urinary nitrite (U-nitrite) were also measured and matched with U-HBP at the time of diagnosis and after a period of treatment. Results: The sensitivity and specificity for U-HBP in the diagnosis of UTI were 95.5% and 96% respectively. U-HBP had the highest sensitivity and specificity in comparison to U IL-6 and U-nitrite in diagnosis of UTI. Also, U-HBP was superior in differentiating pyelonephritis from cystitis, compared with the previous markers and can play a role in the follow up of patients after treatment. Conclusions: A high level of U-HBP is related to UTI and is useful as a prognostic marker to follow up children with UTI after treatment.