The Clinical Value Of Heparin Binding Protein In The Diagnosis Of Urinary Tract Infection

Objective:To investigate the value of urinary heparin binding protein(U-HBP),urinary white blood cell count(U-WBC),urinary bacterial count(U-BAC),urinary nitrite content(NIT)and serum procalcitonin(PCT)in the diagnosis of urinary tract infection(UTI)and asymptomatic bacteriuria(ASB),so as to provide a evidence for the diagnosis of urinary tract infection and the rational use of antibiotics.Methods:From October 2018 to January 2020,147 inpatients suspected of urinary tract infection in the Third Hospital of He bei Province were collected.According to the diagnostic criteria in the consensus of Chinese experts on diagnosis and treatment of urinary tract infection(2015),urinary culture results and whether there is catheter,the patients were divided into urinary tract infection group,asymptomatic bacteriuria group,catheter urine group and negative urinary culture group.Meanwhile,Urine and serum of the patients were collected for the detection of U-HBP,U-WBC,U-BAC,NIT and serum PCT,then the results were statistically analyzed.The receiver operator characteristic curve(ROC curve)was established,the area under the ROC curve was calculated,the optimal cut-off value was found,and the specificity,sensitivity,positive predictive value and negative predictive value of U-HBP,U-WBC,U-BAC,NIT,and PCT in the diagnosis of urinary tract infection were compared.Compare and analyze the usage rate of antibiotics in urinary tract infection and asymptomatic bacteriuria.Results:1.There were significant differences in the concentrations of U-HBP,U-WBC,U-BAC,NIT and PCT among the four groups(P<0.05).2.The difference of U-HBP and U-WBC between urinary tract infection group and asymptomatic bacteriuria group was statistically significant(P<0.05),There were significant differences in the levels of U-HBP,U-WBC,U-BAC,NIT and PCT between urinary tract infection group and culture negative group(P<0.05),The levels of U-HBP,U-BAC and NIT in asymptomatic bacteriuria group and culture negative group were significantly different(P<0.05),There was significant difference between catheterization group and culture negative group(P<0.05).3.The area under ROC curve of U-HBP,U-WBC,U-BAC,NIT and PCT was 0.868,0.768,0.730,0.690 and 0.620 respectively for the diagnosis of urinary tract infection.When a cut-off value of 59.5ng/ml was used in U-HBP,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 79.5%,80%,71.4%,86.2%and 79.8%respectively.4.The pathogenic bacteria of urinary tract infection were gram-negative bacteria(72.7%),gram-positive bacteria(22.2%)and fungi(5.1%),all of which were mainly Escherichia coli,followed by klebsiella pneumoniae,and gram-positive bacteria were mainly enterococcus faecium,enterococcus faecalis and staphylococcus aureus.5.The utilization rate of antibiotics in the urinary tract infection group was higher than that in the asymptomatic bacteriuria group(95.5%vs71.4%,?~2=0.012,P<0.05),and the difference was statistically significant.Conclusions:1.U-HBP,U-WBC,U-BAC,NIT and PCT all have certain value in the diagnosis of urinary tract infection,and U-HBP is a good biomarker for the diagnosis of urinary tract infection2.U-HBP and U-WBC in the urinary tract infection group were higher than that in the asymptomatic bacteriuria group,U-HBP and U-WBC could be used as indicators to distinguish urinary tract infection from asymptomatic bacteriuria3.The main pathogens of urinary tract infection are Gram-negative bacteria,mainly escherichia coli and klebsiella pneumoniae4.Patients with asymptomatic bacteriuria have certain overuse of antibiotics...