Masajtis-Zagajewska Anna, Nowicki Michal
Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Central University Hospital and Teaching Center, Pomorska 251, 92-213 Lodz, Poland.
Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Central University Hospital and Teaching Center, Pomorska 251, 92-213 Lodz, Poland.
Clin Chim Acta. 2017 Aug;471:286-291. doi: 10.1016/j.cca.2017.06.003. Epub 2017 Jun 13.
Urinary tract infection (UTI) is the most common bacterial infection independent of age. It is also one of the most common causes of hospitalizations for infections among elderly people and the most common indication for antibiotic prescriptions in primary care. Both diagnostics and management of lower and upper urinary tract infections provide challenges in clinical practice due to their high prevalence and recurrence, and worldwide increase of antibiotic resistance. The clinical symptoms of UTI are often uncharacteristic or asymptomatic. The accurate diagnosis and early treatment are crucial due to risk of septicaemia and long-term consequences. Currently the diagnosis of urinary tract infection is based on the presence of clinical symptoms in combination with the results of nitrite strip test indicating the presence of bacteria in urine and semi-quantitative measurement of white blood cells count in urine. Although urine culture is the gold standard in UTI diagnostics it is both time-consuming and costly. Searching for novel biomarkers of UTI has attracted much attention in recent years. The article reviews several promising serum and urine biomarkers of UTI such as leukocyte esterase, C-reactive protein, procalcitonin, interleukins, elastase alpha (1)-proteinase inhibitor, lactofferin, secretory immunoglobulin A, heparin-binding protein, xanthine oxidase, myeloperoxidase, soluble triggering receptor expressed on myeloid cells-1, α-1 microglobulin (α1Mg) and tetrazolium nitroblue test (TNB).
尿路感染（UTI）是最常见的非年龄依赖性细菌感染。它也是老年人因感染住院的最常见原因之一，也是初级保健中抗生素处方的最常见指征。由于下尿路感染和上尿路感染的高患病率、高复发率以及全球范围内抗生素耐药性的增加，其诊断和治疗在临床实践中都面临挑战。尿路感染的临床症状通常不典型或无症状。由于存在败血症风险和长期后果，准确诊断和早期治疗至关重要。目前，尿路感染的诊断基于临床症状的存在，结合亚硝酸盐试纸试验结果（表明尿液中存在细菌）以及尿液中白细胞计数的半定量测量。尽管尿培养是尿路感染诊断的金标准，但它既耗时又昂贵。近年来，寻找尿路感染的新型生物标志物备受关注。本文综述了几种有前景的尿路感染血清和尿液生物标志物，如白细胞酯酶、C反应蛋白、降钙素原、白细胞介素、弹性蛋白酶α1-蛋白酶抑制剂、乳铁蛋白、分泌型免疫球蛋白A、肝素结合蛋白、黄嘌呤氧化酶、髓过氧化物酶、髓系细胞表面表达的可溶性触发受体-1、α1微球蛋白（α1Mg）和四氮唑蓝试验（TNB）。
