Pandey S, Aravaanan ASK, Bhaskar E, Silambanan S. Biomarkers innovation in urinary tract infections: Insights into pathophysiology, antibiotic resistance, and clinical applications. World J Nephrol 2025; 14(4): 110749 [DOI: 10.5527/wjn.v14.i4.110749]
Corresponding Author of This Article
Santhi Silambanan, MD, Professor, Department of Biochemistry, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai 600116, Tamil Nādu, India. santhisilambanan@sriramachandra.edu.in
Research Domain of This Article
Urology & Nephrology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 25, 2025 (publication date) through Dec 23, 2025
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Publication Name
World Journal of Nephrology
ISSN
2220-6124
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Pandey S, Aravaanan ASK, Bhaskar E, Silambanan S. Biomarkers innovation in urinary tract infections: Insights into pathophysiology, antibiotic resistance, and clinical applications. World J Nephrol 2025; 14(4): 110749 [DOI: 10.5527/wjn.v14.i4.110749]
Swathi Pandey, Emmanuel Bhaskar, General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, Tamil Nādu, India
Arul Senghor Kadalangudi Aravaanan, Department of Biochemistry, SRM Medical College Hospital and Research Centre, Chennai 603203, Tamil Nadu, India
Santhi Silambanan, Department of Biochemistry, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, Tamil Nādu, India
Co-corresponding authors: Emmanuel Bhaskar and Santhi Silambanan.
Author contributions: Swathi P, Bhaskar E, Aravaanan ASK, and Silambanan S designed the research study, analyzed the data and wrote the manuscript; Swathi P and Silambanan S contributed analytic tools; Bhaskar E and Silambanan S have played important and indispensable roles in the manuscript preparation as the co-corresponding authors; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that there were no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Santhi Silambanan, MD, Professor, Department of Biochemistry, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai 600116, Tamil Nādu, India. santhisilambanan@sriramachandra.edu.in
Received: June 16, 2025 Revised: June 30, 2025 Accepted: October 15, 2025 Published online: December 25, 2025 Processing time: 192 Days and 23.9 Hours
Abstract
Urinary tract infections (UTIs) are the most common bacterial infections. Escherichia coli is the most common cause of UTIs, accounting for 50% of hospital-reported and 90% of community-reported cases. Also, this includes species of Klebsiella, Proteus, Acinetobacter, Pseudomonas, Staphylococcus, Streptococcus, and Enterococcus. 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.
Core Tip: Urinary tract infections (UTIs) are prevalent and often require timely diagnosis to prevent complications. The emerging urinary biomarkers, including 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, have shown potential in identifying infection severity, organ dysfunction, and antibiotic resistance. The review further examines how integrating these biomarkers with advanced biosensor-based diagnostic tools can enhance diagnostic sensitivity, facilitate point-of-care testing, and improve clinical outcomes. The review also underscores the importance of validating and standardizing biomarker-based diagnostics to bridge laboratory innovations with clinical application, ultimately supporting more accurate, rapid, and personalized UTI management.
