Table 1.
Epidemiology and presenting symptoms^ of groups.
Fig 1.
Candidate biomarker ROCs: Area under the curve (AUCs) demonstrating the 8 candidate biomarkers that meet p value filtering criteria and had AUCs > 0.9.
B-cell lymphoma protein (A), C-X-C motif chemokine 6 (B) C-X-C motif chemokine 13 (C), Cathepsin S (D), Heat shock 79kDA protein 1A (E), Mitogen activated protein kinase (F), Protein E7 HPV18 (G) and Transgelin 2 (H) are presented.
Fig 2.
Candidate biomarkers scatterplots: Scatter plots of urine biomarkers that met p value and AUC criteria are presented to show threshold values that differentiate between UTI and no UTI (CN pyuria and CN no pyuria urine).
The CN pyuria and CN no pyuria samples were separated for graphical, but not for determination of the likelihood ratio (LR). Threshold levels and LRs are presented for B-cell lymphoma protein (A), C-X-C motif chemokine 6 (B) C-X-C motif chemokine 13 (C), Cathepsin S (D), Heat shock 79kDA protein 1A (E), Mitogen activated protein kinase (F), Protein E7 HPV18 (G) and Transgelin 2 (H) Y axis units are presented as relative fluorescent units (RFU) of biomarker/ mg creatinine.
Table 2.
Urine biomarker levels (urine biomarker (RFU)/ urine creatinine (mg)).
Fig 3.
Scatter plots for GM-CSF measured adult ED urine samples using an antibody based Mesoscale platform (A) and measured in pediatric ED urine samples using an aptamer based Somalogic platform (B) are presented. AUCs for the antibody based (C) and the aptamer-based platforms were similar. Units for aptamer-based detection are RFU of urine GM-CSF per mg of urine creatinine and units for antibody based detection are pg of urine GM-CSF per mg of urine creatinine. The patients were selected from an adult population from the Ohio State University Wexner Medical Center Emergency Department and included 6 culture positive and 10 culture negative samples. The mean (range) ages in years were 74 (65–89) for the culture positive and 62 (47–74) for the culture negative group. The majority, 4/6 (67%) in the culture positive and 8/10 (80%) in the culture negative group were female. Urine cultures grew E. coli in four patients, E. Faecalis in one patient and both E. coli and E. Faecalis in one patient. Seven of the culture negative group had no growth and three represented by gray boxes grew mixed flora. Of note these results may not differentiate UTI from asymptomatic bacteriuria which will need investigated in future studies.
Fig 4.
The UTI class probability estimate for each sample by the optimal SVM classifier.
The dashed black line shows where the 50% probability lies. Generally, model probability of predicting UTI samples was > 80%. There are 2 outliers, one 18-year old female with CN pyuria (purple arrow) who presented with left flank pain, fever and dysuria along with 1+ LE on UA and had 43.4% UTI probability. The other outlier (purple arrowhead) was a 3-year-old female who presented with fever and abdominal pain, along with 1+ LE and had 62.7% UTI probability.