Sensitivity of C-Reactive Protein and Procalcitonin Measured by Point-of-Care Tests to Diagnose Urinary Tract Infections in Nursing Home Residents:A Cross-Sectional Study

Autor: Cees M.P.M. Hertogh, F. Van Leth, Jan M. Prins, Caroline Schneeberger, Johan Fischer, Sacha D. Kuil, Soemeja Hidad, M. D. de Jong, Janneke Harting
Přispěvatelé: Sociology, Academic Centre for Dentistry Amsterdam, Health Economics and Health Technology Assessment, APH - Methodology, APH - Quality of Care, APH - Global Health, AII - Infectious diseases, Medical Microbiology and Infection Prevention, Laboratory for General Clinical Chemistry, ACS - Heart failure & arrhythmias, ACS - Amsterdam Cardiovascular Sciences, Public and occupational health, APH - Health Behaviors & Chronic Diseases, General Internal Medicine, Infectious diseases, Global Health
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Kuil, S D, Hidad, S, Fischer, J C, Harting, J, Hertogh, C M P M, Prins, J M, de Jong, M D, van Leth, F & Schneeberger, C 2021, ' Sensitivity of C-Reactive Protein and Procalcitonin Measured by Point-of-Care Tests to Diagnose Urinary Tract Infections in Nursing Home Residents : A Cross-Sectional Study ', Clinical Infectious Diseases, vol. 73, no. 11, pp. e3867-e3875 . https://doi.org/10.1093/cid/ciaa1709
Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Clinical Infectious Diseases, 73(11), e3867-e3875. Oxford University Press
Clinical infectious diseases, 73(11), e3867-e3875. Oxford University Press
ISSN: 1058-4838
Popis: Background Diagnosing urinary tract infections (UTIs) in nursing home residents is complex, as specific urinary symptoms are often absent and asymptomatic bacteriuria (ASB) is prevalent. The aim of this study was to assess the sensitivity of blood C-reactive protein (CRP) and procalcitonin (PCT), measured by point-of-care tests (PoCTs), to diagnose UTIs in this setting. Methods Elderly residents (≥65 years old) with a suspected UTI were recruited from psychogeriatric, somatic, or rehabilitation wards across 13 participating nursing homes. CRP and PCT were tested simultaneously in the same study participants. To assess the tests’ sensitivities, a stringent definition of “true” UTI was used that included the presence of symptoms, urinary leucocytes, a positive urine culture, and symptom resolution during antibiotic treatment covering isolated uropathogen(s). The original sample size was 440 suspected UTI episodes, in order to detect a clinically relevant sensitivity of at least 65% when calculated using the matched analysis approach to compare both PoCTs. Results After enrollment of 302 episodes (68.6% of the planned sample size), an unplanned and funder-mandated interim analysis was done, resulting in premature discontinuation of the study for futility. For 247 of 266 eligible episodes, all mandatory items required for the true UTI definition (92.9%) were available. In total, 49 episodes fulfilled our stringent UTI definition (19.8%). The sensitivities of CRP (cut-off, 6.5 mg/L) and PCT (cut-off, 0.025 ng/mL) were 52.3% (95% confidence interval [CI], 36.7–67.5%) and 37.0% (95% CI, 23.2–52.5%), respectively. Conclusions Our results indicate that CRP and PCT are not suitable tests for distinguishing UTI and ASB in nursing home residents. Clinical Trials Registration Netherlands Trial Registry NL6293.
Blood C-reactive protein and procalcitonin measured by point-of-care tests are not suitable to distinguish urinary tract infection and asymptomatic bacteriuria in nursing home residents.
Databáze: OpenAIRE
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