Biomarkers innovation in urinary tract infections: Insights into pathophysiology, antibiotic resistance, and clinical applications

Urinary tract infections (UTIs) are the most common bacterial infections. <i>Escherichia coli</i> is the most common cause of UTIs, accounting for 50% of hospital-reported and 90% of community-reported cases. Also, this includes species of <i>Klebsiella</i>, <i>Proteus</i>, <i>Acinetobacter</i>, <i>Pseudomonas</i>, <i>Staphylococcus</i>, <i>Streptococcus</i>, and <i>Enterococcus</i>. Patients experience cystitis, polyuria, and dysuria. If untreated, this affects the kidneys, further leading to septicemia. UTIs majorly affect adult females (40%-60%). Microbiological culture has been proven to be the standard method. However, it takes 48-72 hours for the tests to be reported. In cases of recurrent UTI, it is mandatory to have a quick, sensitive, and specific diagnostic procedure. Dipstick tests are considered early methods for diagnosing UTIs; however, they have limitations. Recently, biomarkers are being used to assess the severity of the disease. To achieve the United Nations Sustainable Development Goals 3 and 8, the expertise from General Medicine, Biotechnology, and Microbiology come together in achieving the set targets by 2030. In addition to diagnosis of UTI, resistance to antibiotics should not be neglected. This review aimed to examine the clinical relevance of biomarkers such as neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, interleukin (IL) 6, IL-8, heparin-binding protein, procalcitonin, lipopolysaccharide-binding protein, xanthine oxidase, cell-free DNA, and transrenal DNA.