Distribution of uropathogens in patients with malignant tumors and the application of combined blood glucose and urinalysis testing

doi:10.3969/j.issn.1004-583X.2026.05.003

Abstract

Abstract:

Objective To investigate the distribution of uropathogens in patients with urinary tract infection (UTI) and malignant tumors, and to evaluate the diagnostic value of combined urinalysis indices and fasting blood glucose for UTI in this population, providing a reference for early clinical diagnosis. Methods Hospitalized patients with malignant tumors admitted to Fudan University Shanghai Cancer Center from January 2024 to June 2025 were included. Among them, 264 patients with positive urine cultures were assigned to the positive group, and 273 patients with negative urine cultures were assigned to the control group. Urinalysis indices, including nitrite (NIT), leukocyte esterase (LEU), urine white blood cell count (UWBC), urine glucose, and fasting blood glucose, were measured in all participants. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of each indicator and their combined model for UTI. Results A total of 265 pathogens were isolated from the positive group. Gram-negative bacteria accounted for 75.85%, and Gram-positive bacteria accounted for 24.15%. The positive rates of NIT, LEU, urine glucose, UWBC, and the blood glucose level were significantly higher in the positive group than in the control group (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for NIT, LEU, UWBC, and blood glucose in the diagnosis of UTI was 0.637, 0.700, 0.733, and 0.655, respectively. The AUC for the combined detection of these 4 indicators was 0.805, with a sensitivity of 75.00% and a specificity of 77.29%. Conclusion In patients with malignant tumors, the combined detection of urinalysis indices (NIT, LEU, UWBC) and fasting blood glucose has good auxiliary diagnostic value for UTI. Its diagnostic performance is superior to that of individual indicators and may provide a useful reference for early risk assessment and anti-infective decision-making before urine culture results become available.

Key words: neoplasms, urinary tract infection, pathogenic bacteria distribution, urine analysis, blood glucose

CLC Number:

R739.9

Shi Shaoxin, Chen Xueting, Zhuang Yihui, Guo Lin, Lu Renquan, Xu Xiaofeng. Distribution of uropathogens in patients with malignant tumors and the application of combined blood glucose and urinalysis testing[J]. Clinical Focus, 2026, 41(5): 406-410.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.05.003

https://www.lchc.cn/EN/Y2026/V41/I5/406

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References 26

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细菌名称	菌株数(株)	百分比(%)
大肠埃希菌	142	53.58
粪肠球菌	39	14.72
屎肠球菌	13	4.91
奇异变形杆菌	12	4.53
肺炎克雷伯菌	10	3.77
阴沟肠杆菌阴沟亚种	7	2.64
无乳链球菌	5	1.89
不动杆菌属	4	1.51
铜绿假单胞菌	4	1.51
普通变形杆菌	4	1.51
其他	25	9.43
总计	265	100.00

细菌名称	菌株数(株)	百分比(%)
大肠埃希菌	142	53.58
粪肠球菌	39	14.72
屎肠球菌	13	4.91
奇异变形杆菌	12	4.53
肺炎克雷伯菌	10	3.77
阴沟肠杆菌阴沟亚种	7	2.64
无乳链球菌	5	1.89
不动杆菌属	4	1.51
铜绿假单胞菌	4	1.51
普通变形杆菌	4	1.51
其他	25	9.43
总计	265	100.00

组别	例数	NIT(阴性/阳性)	LEU(阴性/阳性)	尿糖(阴性/阳性)	UWBC(个/μL)	血糖(mmol/L)
阳性组	264	185/79	92/172	225/39	129.70(17.83,780.50)	5.88(5.12,7.45)
对照组	273	266/7	179/94	261/12	12.90(2.80,58.40)	5.29(4.91,5.78)
χ²/Z值		75.293	50.473	16.815	9.350	6.223
P值		<0.001	<0.01	<0.01	<0.01	<0.01

组别	例数	NIT(阴性/阳性)	LEU(阴性/阳性)	尿糖(阴性/阳性)	UWBC(个/μL)	血糖(mmol/L)
阳性组	264	185/79	92/172	225/39	129.70(17.83,780.50)	5.88(5.12,7.45)
对照组	273	266/7	179/94	261/12	12.90(2.80,58.40)	5.29(4.91,5.78)
χ²/Z值		75.293	50.473	16.815	9.350	6.223
P值		<0.001	<0.01	<0.01	<0.01	<0.01

项目	AUC	敏感度(%)	特异度(%)	标准误	95%CI
NIT	0.637	29.92	97.44	0.024	0.590~0.684
LEU	0.700	53.41	83.88	0.023	0.656~0.745
UWBC	0.733	67.05	73.26	0.022	0.691~0.775
血糖	0.655	48.48	81.32	0.024	0.609~0.702
联合检测	0.805	75.00	77.29	0.019	0.767~0.842