PMID- 32612372
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220415
IS  - 1178-6973 (Print)
IS  - 1178-6973 (Electronic)
IS  - 1178-6973 (Linking)
VI  - 13
DP  - 2020
TI  - Blood Neutrophil-to-Lymphocyte Ratio and Urine IL-8 Levels Predict the Type of 
      Bacterial Urinary Tract Infection in Type 2 Diabetes Mellitus Patients.
PG  - 1961-1970
LID - 10.2147/IDR.S251966 [doi]
AB  - BACKGROUND: Extended-spectrum ss-lactamase (ESBL)-producing Escherichia coli (E. 
      coli) and Klebsiella pneumoniae (K. pneumoniae) are the most common uropathogens 
      causing UTI (urinary tract infection) in type 2 diabetes mellitus (T2DM). 
      Circulatory inflammatory markers such as C-reactive protein (CRP) and 
      neutrophil-to-lymphocyte ratio (NLR) are usually dysregulated during UTI. 
      However, the differential regulation of these inflammatory signatures during E. 
      coli and K. pneumoniae UTI in T2DM has not been determined. METHODS: A 
      case-control study on 466 patients was performed to investigate the inflammatory 
      signatures indicative of ESBL-E. coli and K. pneumoniae UTIs in T2DM. Serum CRP 
      levels and blood NLR for these patients were determined and associated with E. 
      coli and K. pneumoniae ESBL uropathogen using multivariate logistic regression 
      analysis. Urinary interleukin 8 (IL-8) levels were also assessed and associated 
      with these two UTI uropathogens in T2DM. The association of the two 
      ESBL-uropathogens with the survival outcomes of T2DM patients was also analyzed 
      using Cox-proportional hazard model. RESULTS: T2DM patients with ESBL-E. coli UTI 
      had lower serum CRP levels (median, CRP mg/dL 33.7 vs 39.8, respectively; 
      P=0.023) and higher blood NLR (median, NLR 3.2 vs 2.6, respectively; P=0.010) 
      compared to those with K. pneumoniae UTIs (P<0.001). Moreover, in T2DM, the 
      urinary IL-8 levels was higher in ESBL-E. coli compared to those with K. 
      pneumoniae UTIs (P<0.0001). After adjusting for confounders, including age, 
      gender, serum albumin, hemoglobulin, leukocytes, and platelet counts, T2DM 
      patients with blood NLR >/= 3.5 were at higher risk for ESBL-E. coli UTIs than 
      ESBL-K. pneumoniae UTIs (odds ratio [OR], 3.61, 95% confidence interval, Cl, 
      1.49-8.73; P=0.004). Moreover, T2DM patients with ESBL-E. coli UTIs had higher 
      all-cause mortality (hazard ratio [HR], 4.09; 95%, 1.14-14.59) than those with K. 
      pneumoniae UTIs. CONCLUSION: Serum CRP levels, blood NLR, and IL-8 urinary levels 
      differentiate ESBL-E. coli from K. pneumoniae UTIs in T2DM.
CI  - (c) 2020 Saheb Sharif-Askari et al.
FAU - Saheb Sharif-Askari, Fatemeh
AU  - Saheb Sharif-Askari F
AUID- ORCID: 0000-0001-8498-055X
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
FAU - Saheb Sharif-Askari, Narjes
AU  - Saheb Sharif-Askari N
AUID- ORCID: 0000-0003-0482-6777
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
FAU - Guella, Adnane
AU  - Guella A
AUID- ORCID: 0000-0002-4026-4268
AD  - Department of Nephrology, University Hospital Sharjah, Sharjah, United Arab 
      Emirates.
FAU - Alabdullah, Ali
AU  - Alabdullah A
AUID- ORCID: 0000-0002-8632-2144
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
FAU - Bashar Al Sheleh, Hour
AU  - Bashar Al Sheleh H
AUID- ORCID: 0000-0002-8931-3999
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
FAU - Maher Hoory AlRawi, Afnan
AU  - Maher Hoory AlRawi A
AUID- ORCID: 0000-0002-6583-0115
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
FAU - Sami Haddad, Enad
AU  - Sami Haddad E
AUID- ORCID: 0000-0002-8947-0695
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
FAU - Hamid, Qutayba
AU  - Hamid Q
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
AD  - Department of Clinical Sciences, College of Medicine, University of Sharjah, 
      Sharjah, United Arab Emirates.
FAU - Halwani, Rabih
AU  - Halwani R
AUID- ORCID: 0000-0002-6516-7771
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
AD  - Department of Clinical Sciences, College of Medicine, University of Sharjah, 
      Sharjah, United Arab Emirates.
AD  - Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of 
      Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
FAU - Hamoudi, Rifat
AU  - Hamoudi R
AUID- ORCID: 0000-0002-1402-0868
AD  - Sharjah Institute of Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
AD  - Department of Clinical Sciences, College of Medicine, University of Sharjah, 
      Sharjah, United Arab Emirates.
LA  - eng
PT  - Journal Article
DEP - 20200624
PL  - New Zealand
TA  - Infect Drug Resist
JT  - Infection and drug resistance
JID - 101550216
PMC - PMC7323571
OTO - NOTNLM
OT  - C-reactive protein
OT  - Escherichia coli
OT  - Klebsiella pneumoniae
OT  - extended-spectrum ss-lactamase
OT  - survival
OT  - urinary tract infection
COIS- Rabih Halwani and Rifat Hamoudi are co-senior authors. All authors declare that 
      they have no competing interests.
EDAT- 2020/07/03 06:00
MHDA- 2020/07/03 06:01
PMCR- 2020/06/24
CRDT- 2020/07/03 06:00
PHST- 2020/03/01 00:00 [received]
PHST- 2020/05/26 00:00 [accepted]
PHST- 2020/07/03 06:00 [entrez]
PHST- 2020/07/03 06:00 [pubmed]
PHST- 2020/07/03 06:01 [medline]
PHST- 2020/06/24 00:00 [pmc-release]
AID - 251966 [pii]
AID - 10.2147/IDR.S251966 [doi]
PST - epublish
SO  - Infect Drug Resist. 2020 Jun 24;13:1961-1970. doi: 10.2147/IDR.S251966. 
      eCollection 2020.