{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:43:29Z","timestamp":1791517409085,"version":"4.3.4"},"reference-count":44,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Southern Denmark","award":["A797"],"award-info":[{"award-number":["A797"]}]},{"name":"University of Southern Denmark","award":["21\/9582"],"award-info":[{"award-number":["21\/9582"]}]},{"name":"University of Southern Denmark","award":["152-A6002"],"award-info":[{"award-number":["152-A6002"]}]},{"name":"University of Southern Denmark","award":["110-A4671"],"award-info":[{"award-number":["110-A4671"]}]},{"name":"University of Southern Denmark","award":["A5733"],"award-info":[{"award-number":["A5733"]}]},{"name":"Odense University Hospital, Hospital S\u00f8nderjylland, Aabenraa","award":["A797"],"award-info":[{"award-number":["A797"]}]},{"name":"Odense University Hospital, Hospital S\u00f8nderjylland, Aabenraa","award":["21\/9582"],"award-info":[{"award-number":["21\/9582"]}]},{"name":"Odense University Hospital, Hospital S\u00f8nderjylland, Aabenraa","award":["152-A6002"],"award-info":[{"award-number":["152-A6002"]}]},{"name":"Odense University Hospital, Hospital S\u00f8nderjylland, Aabenraa","award":["110-A4671"],"award-info":[{"award-number":["110-A4671"]}]},{"name":"Odense University Hospital, Hospital S\u00f8nderjylland, Aabenraa","award":["A5733"],"award-info":[{"award-number":["A5733"]}]},{"name":"Ingemann O. Bucks foundation","award":["A797"],"award-info":[{"award-number":["A797"]}]},{"name":"Ingemann O. Bucks foundation","award":["21\/9582"],"award-info":[{"award-number":["21\/9582"]}]},{"name":"Ingemann O. Bucks foundation","award":["152-A6002"],"award-info":[{"award-number":["152-A6002"]}]},{"name":"Ingemann O. Bucks foundation","award":["110-A4671"],"award-info":[{"award-number":["110-A4671"]}]},{"name":"Ingemann O. Bucks foundation","award":["A5733"],"award-info":[{"award-number":["A5733"]}]},{"name":"Guldsmed A L Rasmussens Foundation","award":["A797"],"award-info":[{"award-number":["A797"]}]},{"name":"Guldsmed A L Rasmussens Foundation","award":["21\/9582"],"award-info":[{"award-number":["21\/9582"]}]},{"name":"Guldsmed A L Rasmussens Foundation","award":["152-A6002"],"award-info":[{"award-number":["152-A6002"]}]},{"name":"Guldsmed A L Rasmussens Foundation","award":["110-A4671"],"award-info":[{"award-number":["110-A4671"]}]},{"name":"Guldsmed A L Rasmussens Foundation","award":["A5733"],"award-info":[{"award-number":["A5733"]}]},{"name":"Gundhild Andersen\u2019s Foundation","award":["A797"],"award-info":[{"award-number":["A797"]}]},{"name":"Gundhild Andersen\u2019s Foundation","award":["21\/9582"],"award-info":[{"award-number":["21\/9582"]}]},{"name":"Gundhild Andersen\u2019s Foundation","award":["152-A6002"],"award-info":[{"award-number":["152-A6002"]}]},{"name":"Gundhild Andersen\u2019s Foundation","award":["110-A4671"],"award-info":[{"award-number":["110-A4671"]}]},{"name":"Gundhild Andersen\u2019s Foundation","award":["A5733"],"award-info":[{"award-number":["A5733"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Urinary tract infections (UTIs) are a leading bacterial infection in the emergency department (ED). Diagnosing UTIs in the ED can be challenging due to the heterogeneous presentation; therefore, fast and precise tests are needed. We aimed to evaluate the diagnostic precision of procalcitonin (PCT), soluble urokinase plasminogen activator receptors (suPARs), and C-reactive protein (CRP) in diagnosing UTIs, grading the severity of UTIs, and ruling out bacteremia. Methods: We recruited adults admitted to three Danish EDs with suspected UTIs. PCT, suPAR, and CRP were used in index tests, while blood cultures, expert panel diagnosis, and severity grading were used in the reference tests. Logistic regression and area under the receiver operator characteristic curves (AUROCs) were utilized to evaluate the models and determine the optimal cut-offs. Results: We enrolled 229 patients. PCT diagnosed UTI with an AUROC of 0.612, detected severe disease with an AUROC of 0.712, and ruled out bacteremia with an AUROC of 0.777. SuPAR had AUROCs of 0.480, 0.638, and 0.605, while CRP had AUROCs of 0.599, 0.778, and 0.646. Conclusions: The diagnostic performance of PCT, suPAR, or CRP for UTIs or to rule out severe disease was poor. However, PCT can safely rule out bacteremia in clinically relevant numbers in ED patients suspected of UTI.<\/jats:p>","DOI":"10.3390\/jcm13061776","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T09:14:33Z","timestamp":1710926073000},"page":"1776","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Diagnostic Accuracy of Procalcitonin, Soluble Urokinase-Type Plasminogen Activator Receptors, and C-Reactive Protein in Diagnosing Urinary Tract Infections in the Emergency Department\u2014A Diagnostic Accuracy Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8064-7642","authenticated-orcid":false,"given":"Mathias Amdi","family":"Hertz","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Infectious Diseases, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2189-9823","authenticated-orcid":false,"given":"Isik Somuncu","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Infectious Diseases, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2129-328X","authenticated-orcid":false,"given":"Flemming S.","family":"Rosenvinge","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8654-2449","authenticated-orcid":false,"given":"Claus Lohman","family":"Brasen","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"Department of Biochemistry and Immunology, Lilleb\u00e6lt Hospital\u2014Kolding, University Hospital of Southern Denmark, 6000 Kolding, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-6976","authenticated-orcid":false,"given":"Eline Sandvig","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"Department of Biochemistry and Immunology, Lilleb\u00e6lt Hospital\u2014Kolding, University Hospital of Southern Denmark, 6000 Kolding, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6451-2978","authenticated-orcid":false,"given":"Anne","family":"Heltborg","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3147-3030","authenticated-orcid":false,"given":"Thor Aage","family":"Skovsted","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Immunology, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Rabing Brix","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Immunology, Lilleb\u00e6lt Hospital\u2014Kolding, University Hospital of Southern Denmark, 6000 Kolding, Denmark"},{"name":"Department of Biochemistry and Immunology, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0923-6960","authenticated-orcid":false,"given":"Mariana Bichuette","family":"Cartuliares","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stig L\u00f8nberg","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Infectious Diseases, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Backer","family":"Mogensen","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Skj\u00f8t-Arkil","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.idc.2013.09.003","article-title":"Urinary tract infection syndromes: Occurrence, recurrence, bacteriology, risk factors, and disease burden","volume":"28","author":"Foxman","year":"2014","journal-title":"Infect. 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