The Prevalence and Association of Different Uropathogens Detected by M-PCR with Infection-Associated Urine Biomarkers in Urinary Tract Infections

Figures & data

Table 1 Biomarker Positivity Cutoffs

Biomarker	Cutoff
Neutrophil gelatinase-associated lipocalin (NGAL)	≥ 38.0 ng/mL
Interleukin 8 (IL-8)	≥ 20.6 pg/mL
Interleukin 1 beta (IL-1β)	≥ 12.4 pg/mL

Table 2 Demographics of the Study Cohort

Demographics
Age
Mean (SD)	76.6 (8.72)
Median [Min, Max]	76.3 [60.0, 103]
Sex
Female	752 (66.4%)
Male	380 (33.6%)
Total	1132

Figure 1 Organism detection prevalence.

Note: Organisms or organism groups are arranged on the y-axis in descending order of detection prevalence. Bar length along the x-axis represents the percent of M-PCR-positive specimens (microbial density ≥ 10,000 cells/mL for bacteria/bacterial groups or > 0 cells/mL for yeasts). The number (n) of detections are shown with labels at the end of each bar.

Table 3 Biomarker Positivity in Groups of Five Organisms by Prevalence

Organisms as Detected at Density ≥ 10,000 by M-PCR, in Order of Prevalence	M-PCR Positivity	Individual and Consensus Biomarker Positivity Among All M-PCR-Positive Cases
	n (%) of M-PCR Positive Cases	Consensus n (%) of M-PCR Positive Cases	NGAL n (%) of M-PCR Positive Cases	IL-8 n (%) of M-PCR Positive Cases	IL-1β n (%) of M-PCR Positive Cases
Overall M-PCR Positive Cases	823 (100%)	661 (80%)	670 (81%)	709 (86%)	529 (64%)
5 Most Prevalent Organisms (Escherichia coli, Aerococcus urinae, Actinobaculum schaalii, Enterococcus faecalis, Viridans Group Streptococcus)	648 (79%)	517 (80%)	526 (81%)	556 (86%)	415 (64%)
Next 5 (Klebsiella pneumoniae, Gardnerella vaginalis, Coagulase Negative Staphylococcus, Pseudomonas aeruginosa, Proteus mirabilis)	272 (33%)	226 (83%)	228 (84%)	240 (88%)	181 (67%)
Next 5 (Alloscardovia omnicolens, Enterobacter group, Streptococcus agalactiae, Candida glabrata, Enterococcus faecium)	117 (14%)	98 (84%)	98 (84%)	101 (86%)	74 (63%)
Next 5 (Candida albicans, Ureaplasma urealyticum, Klebsiella oxytoca, Morganella morganii, Citrobacter freundii)	60 (7%)	54 (90%)	54 (90%)	54 (90%)	46 (77%)
Next 5 (Corynebacterium riegelii, Staphylococcus aureus, Mycoplasma hominis, Citrobacter koseri, Candida parapsilosis)	26 (3%)	24 (92%)	25 (96%)	24 (92%)	18 (69%)
5 Least Prevalent Organisms (Serratia marcescens, Candida auris, Providencia stuartii, Acinetobacter baumannii, Pantoea agglomerans)	4 (<1%)	2 (50%)	2 (50%)	4 (100%)	2 (50%)

Notes: Biomarker positivity is presented by the total number and percentage of multiplex polymerase chain reaction (M-PCR) positives for each microbe-prevalence group.

Table 4 Biomarker Positivity in M-PCR Positive versus Negative Cases

Total n = 1132	M-PCR		Consensus		NGAL		IL-8		IL-1β
	n	% of Total	% Positive (n)	p-value vs Negative	% Positive (n)	p-value vs Negative	% Positive (n)	p-value vs Negative	% Positive (n)	p-value vs Negative
M-PCR Negative cases	309	27	35% (108)		39% (119)		50% (156)		22% (67)
M-PCR Positive cases	823	73	80% (661)	<0.0001	81% (670)	<0.0001	86% (709)	<0.0001	64% (529)	<0.0001

Note: Bolded values indicate p < 0.05.

Table 5 Biomarker Positivity in M-PCR Positive Cases Grouped by Organism and Infection Characteristics

Total n = 823	M-PCR		Consensus		NGAL		IL-8		IL-1β
	n	% of Total	% Positive (n)	p-value vs Negative	% Positive (n)	p-value vs Negative	% Positive (n)	p-value vs Negative	% Positive (n)	p-value vs Negative
Mono-microbial cases	301	37	82% (246)	<0.0001	81% (243)	<0.0001	89% (269)	<0.0001	67% (201)	<0.0001
Poly-microbial cases	522	63	80% (415)	<0.0001	82% (427)	<0.0001	84% (440)	<0.0001	63% (328)	<0.0001
Cases with E. coli	336	41	86% (289)	<0.0001	86% (289)	<0.0001	91% (305)	<0.0001	72% (243)	<0.0001
Cases without E. coli	487	59	76% (372)	<0.0001	78% (381)	<0.0001	83% (404)	<0.0001	59% (286)	<0.0001
Cases with only emerging uro-pathogens	109	13	74% (81)	<0.0001	83% (90)	<0.0001	78% (85)	<0.0001	55% (60)	<0.0001
Cases with only classical uro-pathogens	442	54	78% (345)	<0.0001	76% (337)	<0.0001	86% (379)	<0.0001	63% (280)	<0.0001

Note: Bolded values indicate p < 0.05.

Figure 2 Biomarker consensus percent positivity by microbial identification.

Notes: Organisms or organism groups are listed on the y-axis in descending order of detection prevalence. Bar length along the x-axis represents the percentage of positive specimens (microbial density ≥ 10,000 cells/mL for bacteria/bacterial groups or > 0 cells/mL for yeasts) that are also positive for biomarker consensus. Labels at the end of each bar show the associated biomarker consensus percentage and the number of biomarker consensus positive specimens out of the total number of specimens positive for that organism (in parenthesis).