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The Value of Interleukin Levels in the Diagnosis of Febrile Urinary Tract Infections in Children and Adolescents; a Systematic Review and Meta-Analysis Publisher Pubmed



Hosseini M1, 2 ; Ahmadzadeh H3 ; Toloui A4 ; Ahmadzadeh K4 ; Madani Neishaboori A4 ; Rafiei Alavi SN4 ; Gubari MIM5 ; Jones ME6 ; Ataei F7 ; Yousefifard M4 ; Ataei N1
Authors
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Authors Affiliations
  1. 1. Pediatrics Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Community Medicine, College of Medicine, University of Sulaimani, Sulaimani, Iraq
  6. 6. Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
  7. 7. Department of Nuclear Medicine, Valiasr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran

Source: Journal of Pediatric Urology Published:2022


Abstract

Introduction: In recent years, researchers have been looking for tools and biomarkers to identify urinary tract infections (UTI) in children. Since there exists no systematic reviews and meta-analyses on the matter, the present study intends to determine the diagnostic value of serum and urinary levels of interleukins (IL) in the diagnosis of febrile UTI in children and adolescents. Methods: Medline, Embase, Scopus, and Web of Science were searched until the end of 2020, using keywords related to UTI and serum and urinary ILs. Two independent researchers included relevant studies and summarized the data. Analyzed data were reported as standardized mean difference (SMD) with 95% confidence interval (CI). Results: Data from 23 articles were included in the present study. Analyses showed that IL-6, IL-8, IL 1 beta and IL-1 alpha urinary levels are significantly higher in children with UTI than that of other children. Moreover, serum levels of IL-6 and IL-8 in children with UTI were significantly higher than that of healthy children. However, IL-6 and IL-8 serum levels were not significantly different between children with UTI and non-UTI febrile group. Finally, the area under the curve of urinary IL-6 and IL-8 and serum IL-8 levels in the diagnosis of pediatric UTIs were 0.89 (95% CI: 0.86, 0.92), 0.95 (95% CI: 0.92, 0.96) and 0.80 (95% CI: 0.77, 0.84), respectively. Conclusion: The findings of the present study showed that the diagnostic utility of ILs 8 and 6 urinary levels is most desirable in the detection of febrile UTIs from other febrile conditions in children and adolescents, in comparison with the diagnostic utility of other ILs’ urinary and serum levels in the detection of febrile UTI. However, even after nearly 3 decades of research on these biomarkers, their optimal cut-off points in diagnosing pediatric UTIs are still to be determined in further studies. © 2022 Journal of Pediatric Urology Company
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