MP46-12 USEFULNESS OF PRESEPSIN FOR DETECTING SEPSIS IN URINARY-TRACT INFECTIONS

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I (MP46)1 Apr 2020MP46-12 USEFULNESS OF PRESEPSIN FOR DETECTING SEPSIS IN URINARY-TRACT INFECTIONS Yoshitaka Sekine*, Kazuhiko Kotani, Daisuke Oka, Hiroshi Nakayama, Yoshiyuki Miyazawa, Takahiro Syuto, Seiji Arai, Masashi Nomura, Hidekazu Koike, Hiroshi Matsui, Yasuhiro Shibata, and Kazuhiro Suzuki Yoshitaka Sekine*Yoshitaka Sekine* More articles by this author , Kazuhiko KotaniKazuhiko Kotani More articles by this author , Daisuke OkaDaisuke Oka More articles by this author , Hiroshi NakayamaHiroshi Nakayama More articles by this author , Yoshiyuki MiyazawaYoshiyuki Miyazawa More articles by this author , Takahiro SyutoTakahiro Syuto More articles by this author , Seiji AraiSeiji Arai More articles by this author , Masashi NomuraMasashi Nomura More articles by this author , Hidekazu KoikeHidekazu Koike More articles by this author , Hiroshi MatsuiHiroshi Matsui More articles by this author , Yasuhiro ShibataYasuhiro Shibata More articles by this author , and Kazuhiro SuzukiKazuhiro Suzuki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000901.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary-tract infections are common diseases, and sometimes progress to sepsis or septic shock which can be lethal. Therefore, the diagnosis and severity of sepsis are important at the beginning of the treatment. Recently, presepsin is reported to be a biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients, but there are few reports about urinary-tract infections. The objective of this study is to evaluate whether presepsin is a useful marker for detecting severe sepsis, and whether it can predict the therapeutic courses in urinary-tract infections compared with other markers, such as procalcitonin (PCT) and C-reactive protein (CRP). METHODS: From April 2014 to December 2016, a total of 50 patients, who were admitted into Gunma university hospital with urinary-tract infections, were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC), causative diseases of urinary-tract infections and other data were evaluated at the enrollment, third and fifth days. The patients were divided into two groups; with (n=11) or without (n=39) septic shock at the enrollment day, and with (n=7) or without (n=43) sepsis at the fifth day, respectively.This study was approved by the institutional review board of Gunma University Hospital (No.1650). RESULTS: Concerning the enrollment day, elevated presepsin (≥ 500 pg/mL), elevated PCT (≥ 2 ng/ml), elevated GOT (≥ 34 U/L), elevated gamma GTP (≥ 47 U/L), elevated creatinine (men; ≥1.07 mg/dl, women; ≥0.79 mg/dl) were correlated with septic shock in the univariate analysis. Multivariate logistic regression analysis showed that elevated presepsin (≧ 500 pg/ml) was an independent risk factor associated with septic shock (p=0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) at 0.860 for presepsin (vs. 0.621, 0.536 and 0.480 for PCT, CRP and WBC, respectively). On the other hand, elevated presepsin (≥ 500 pg/mL), elevated PCT (≥ 2 ng/ml) and urinary calculi were correlated with sepsis at the fifth day in the univariate analysis. Multivariate logistic regression analysis showed that elevated PCT (≥ 2 ng/ml) was an independent risk factor associated with sepsis at the fifth day. ROC curve for diagnosing sepsis at the fifth day indicated an AUC at 0.837 for PCT (vs. 0.817, 0.811 and 0.802 for presepsin, CRP and WBC, respectively). CONCLUSIONS: This study showed that presepsin may be a good marker for diagnosis of severe patients who need intensive care at the data of admission, and PCT may be a good marker for predicting hard-to-treat cases in urinary-tract infections. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e678-e678 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yoshitaka Sekine* More articles by this author Kazuhiko Kotani More articles by this author Daisuke Oka More articles by this author Hiroshi Nakayama More articles by this author Yoshiyuki Miyazawa More articles by this author Takahiro Syuto More articles by this author Seiji Arai More articles by this author Masashi Nomura More articles by this author Hidekazu Koike More articles by this author Hiroshi Matsui More articles by this author Yasuhiro Shibata More articles by this author Kazuhiro Suzuki More articles by this author Expand All Advertisement PDF downloadLoading ...