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Preliminary study on serum paraoxonase-1 status and chemokine (C-C motif) ligand 2 in hospitalized elderly patients with catheter-associated asymptomatic bacteriuria

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

An Erratum to this article was published on 19 July 2016

Abstract

Urinary tract infections (UTI) are common among elderly patients in residential care facilities, as well as in the hospital setting. Identifying new biochemical markers of UTI is an active line of research since UTI management is resource intensive. Paraoxonase-1 (PON1) forms part of the patient’s immune system, the response-to-injury and inflammation. Our study sought to evaluate alterations in inflammation-related paraoxonase-1 (PON1) and chemokine (C-C motif) ligand 2 (CCL2) in patients with an indwelling catheter to assess their potential usefulness as biomarkers of infection. Patients (n = 142) who had had the urinary catheter removed and 100 healthy volunteers were recruited. In all participants we measured serum PON1 activity, PON1 concentration, CCL2, procalcitonin and C-reactive protein (CRP). Results indicated that patients had higher CCL2, CRP and procalcitonin concentrations than the control group, and lower paraoxonase activity. There were no significant differences in PON1 concentrations. When comparing the diagnostic accuracy of CRP, procalcitonin, CCL2 and the PON1-related variables in discriminating between patients with and those without UTI, we found a considerable degree of overlap between groups, i.e., a low diagnostic accuracy. However, there were significant inverse logarithmic correlations between serum paraoxonase activity and the number of days the urinary catheter had been in situ. Our results suggest that measurement of these biochemical variables may be useful in investigating complications of long-term use of these devices and help to improve the economic and clinical investment required in the management of the often-associated infection.

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Abbreviations

ACI:

Acute concomitant infection

DTNB:

5,5′-dithio-bis-2-nitrobenzoic acid

CAAB:

Catheter-associated asymptomatic bacteriuria

CAUTI:

Catheter-associated urinary tract infection

CCL2:

Chemokine (C-C motif) ligand 2

CRP:

C-reactive protein

PON1:

Paraoxonase-1

ROC:

Receiver operating characteristic

TBBL:

5-thiobutyl butyrolactone

UTI:

Urinary tract infection

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Acknowledgments

This study was supported by grants from the Instituto de Salud Carlos III (PI1102817 and PI1100130) and the Fondo Europeo de Desarrollo Regional (FEDER), Madrid, Spain. We thank Dr. Dan Tawfik from the Weizmann Institute of Science (Rehovot, Israel) for the generous gift of the TBBL reagent. Editorial assistance was provided by Dr. Peter R. Turner of t-scimed.

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Authors and Affiliations

  1. Department of Internal Medicine, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Unitat de Recerca Biomèdica, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain

    S. Iftimie, J. Joven & J. Camps

  2. Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, C. Sant Joan, s/n, 43201, Reus, Catalonia, Spain

    A. García-Heredia, I. Fort-Gallifa & A. Castro

  3. Laboratori de Referència Sud, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Av. Comerç 42, 43204, Reus, Catalonia, Spain

    I. Pujol, F. Ballester, I. Fort-Gallifa & J. M. Simó

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  1. S. Iftimie
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  2. A. García-Heredia
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Correspondence to J. Camps.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study

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Iftimie, S., García-Heredia, A., Pujol, I. et al. Preliminary study on serum paraoxonase-1 status and chemokine (C-C motif) ligand 2 in hospitalized elderly patients with catheter-associated asymptomatic bacteriuria. Eur J Clin Microbiol Infect Dis 35, 1417–1424 (2016). https://doi.org/10.1007/s10096-016-2679-8

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