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Article Type

Original Study

Abstract

Objective The aim of this study was to assess serum levels of lipocalin-2 in hepatic patients with bacterial infection and evaluate the role of lipocalin-2 as a diagnostic marker for bacterial infection. Background Lipocalin-2 is a 25-kDa protein present in peroxidase-negative granules of neutrophils, colocalized with lactoferrin, and is released following neutrophil activation. Lipocalin-2 exerts bacteriostatic effects, which are explained by its ability to capture and deplete siderophores, small iron-binding molecules that are synthesized by certain bacteria as a means of iron acquisition. Patients and methods Eighty patients divided into three groups were included in the study: group 1 included 40 hepatic patients with bacterial infection; group 2 included 20 hepatic patients without bacterial infection; and group 3 included 20 healthy patients as the control group. Liver function tests, complete blood count, evaluation of serum level of C reactive protein, and serum measurement of lipocalin-2 were carried out in all groups. Microbiological examination (blood, urine, sputum, and ascetic fluid cultures) was performed for patients. Results Serum level of lipocalin-2 was significantly increased in hepatic patients with bacterial infection than in other groups (P ≤ 0.0001). Lipocalin-2 at cutoff less than 60 ng/ml could predict bacterial infection with 90% sensitivity and 72% specificity. Conclusion Lipocalin-2 is an excellent predictive biomarker of bacterial infection. It can be used as a diagnostic marker with better sensitivity and specificity than C reactive protein for the diagnosis of bacterial infection, especially in chronic liver disease.

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