Urinary Heparin Binding Protein: an Effective Marker in Assessing the Severity of UTI Compared to Microscopic Urinalysis.

Abstract

Background: Proper and fast diagnosis of urinary tract infections (UTIs) is essential for suitable treatment strategy. Urine culture is the mainstay of diagnostic approaches, but it could be time consuming. Relying on clinical features alone may be misleading and may affect the precision of antibiotic regime. That is why utilizing specific biomarkers such as urinary heparin binding protein (UHBP) may support a more accurate diagnosis and thus a suit-able antibiotic choice. In the current work, we aimed to assess the validity of UHBP in distinguishing UTI and whether it is suitable for determining the different severity levels of UTI.

Methods: Eighty-seven individuals (71 patients, 16 controls) with different ages were recruited in the current study. Participants were attending the urology outpatient clinic in Al Rabie hospital with suspected UTI based on clinical features, microscopic, and culture analysis. Urine samples were collected and inspected for UHBP by enzyme-linked immunosorbent assay (ELISA) kit. Microscopic analysis involved red blood cells (RBC), epithelial cells (EC), pus cells (PC), white blood cells (WBC), or leukocytes counts.

Results: UHBP showed a significantly high level in UTI patients compared to controls, which parallels the microscopic findings. Categorization of individuals' UHBP results according to the different values of microscopic analysis revealed strong association with the level of UHBP. Based on clinical features, UHBP levels varied significant-ly with UTI severity, showing significantly elevated UHBP levels (432.4 ± 82.8 pg/mL) in the severe group com-pared to both the moderate (252.8 ± 79.9 pg/mL, p < 0.001) and mild (55.2 ± 39.3 pg/mL, p < 0.001) groups. Additionally, the moderate group exhibited significantly higher UHBP levels compared to the mild group (p < 0.001). Receiver-operating characteristics (ROC) analysis indicated the power of UHBP in distinguishing the levels of severity of UTI with an area under the curve (AUC) of 0.98 (p < 0.001).

Conclusions: UHBP is a valid biomarker in distinguishing UTI individuals. It also emerged as an effective marker in detecting the severity of UTI, which could help in distinguishing upper and lower UTIs and supports a more accurate diagnostic scheme.