Screening Biomarkers and Constructing a Predictive Model for Symptomatic Urinary Tract Infection and Asymptomatic Bacteriuria in Patients Undergoing Cutaneous Ureterostomy: A Metagenomic Next-Generation Sequencing Study

Overview

Journal Dis Markers

Publisher Wiley

Specialty Biochemistry

Date 2022 May 9

PMID 35531475

Authors

Qian Yuan

Rong Huang

Liping Tang

Lijuan Yuan

Li Gao

Yang Liu

Ying Cao

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the clinical diagnostic value of differential flora as biomarkers in patients with symptomatic urinary tract infection (UTI) and asymptomatic bacteriuria (ASB) undergoing cutaneous ureterostomy based on metagenomic next-generation sequencing and construct predictive models to provide a scientific reference for clinical diagnosis and treatment. . According to standard procedures, samples were taken from each patient for routine tests (urine, ureteral stent, and skin swab around the stoma). Cytokine levels in the blood were also detected. Urinary microflora were measured by mNGS, and potential biomarkers for distinguishing UTI and ASB were identified by differential flora. Finally, we generated the predictive models for ASB and UTI using the Lasso method and cytokine levels.

Results: Urine culture was performed for 50 patients with cutaneous ureterostomy; 44 of these patients developed bacteriuria. The incidence of symptomatic bacteriuria was 54.55%. Biomarker analysis showed that , , , , and all had good predictive performance and were combined in a single model. The predictive model exhibited good prediction performance (area under the curve (AUC) = 0.8729, sensitivity = 80%, specificity = 83.3%, and cutoff = 1.855). We also identified a significant negative correlation between the weight sum of the abundance for these five characteristic pathogens (Sum_weighted_Reads) and levels of the cytokine IL-6 and IL-1 ( < 0.05).

Conclusion: mNGS had a higher positive detection rate for pathogens in urine samples. The selected differential bacteria can be used as biomarkers of ASB and UTI, and the prediction model has good predictive performance. Analysis also showed that the occurrence of symptoms was related to individual immunity. Combined with the Sum_weighted_Reads cutoff and cytokine levels (IL-6 and IL-1) of differential flora, it was possible to judge the severity of symptoms in cutaneous ureterostomy patients with bacteriuria and provide new insights for the treatment and intervention of ASB and UTI.

Citing Articles

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Haley E, Luke N, Mathur M, Festa R, Wang J, Jiang Y Eur Urol Open Sci. 2023; 58:73-81.

PMID: 38152485 PMC: 10751541. DOI: 10.1016/j.euros.2023.10.008.

Elevated UTI Biomarkers in Symptomatic Patients with Urine Microbial Densities of 10,000 CFU/mL Indicate a Lower Threshold for Diagnosing UTIs.

Parnell L, Luke N, Mathur M, Festa R, Haley E, Wang J Diagnostics (Basel). 2023; 13(16).

PMID: 37627948 PMC: 10453813. DOI: 10.3390/diagnostics13162688.

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