AGEM Author Spotlight December 2023

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Published Work by AGEM Member:  
Jeffrey Caterino, MD Professor and Chair of the Department of Emergency Medicine, Professor of Internal Medicine, and Chief of Emergency Medical Services for The Ohio State University

Establishment of baseline urinary antimicrobial peptide levels by age: a prospective observational study



We continue to struggle with the diagnosis of urinary tract infection in older adults. What is relatively straightforward in the younger population becomes increasingly difficult with age due to confounding clinical information, nonspecific testing results, and lack of culture data in the ED. This work is some of the first steps in looking at novel diagnostic markers, antimicrobial peptides (AMPs) for their potential to aid in UTI diagnosis in older adults. AMPs are part of the innate immune response, an important factor in both preventing and responding to UTI. In this study, we examined urinary levels of four AMPs in subjects of varying age to determine if there are baseline differences in their values. The goal was to determine if there were any differences in "normal" with aging so that this could be accounted for in future studies. Only one of the four showed a difference. Human beta defensin-2 actually had lower baseline levels in older adults, the others had no change. His work will be important to our follow-on study, recently completed with data being analyzed of older adults in the emergency department with suspected UTI. Will be determining what combination of history, exam, current diagnostic tests, and AMPs allows for the most accurate diagnosis of UTI in older adults given the information available to the ED physician. The hope is that this moves the bar forward on accurate UTI diagnosis in this population.



I joined the faculty at Ohio State after completing a residency in emergency and internal medicine at Allegheny General Hospital in 2004. I've now been at Ohio State for 20 years and have held various roles. For much of that time my primary focus was researching geriatric emergencies, particularly UTI diagnostics. I received Jahnigen and NIH Beeson career development grants followed by an R01 from NIA. I also helped write the initial Geriatric ED Guidelines and have been tremendously privileged to benefit from the mentorship and collaboration of so many in the geriatric emergency medicine community. I've held various roles including Vice Chair for Research in the department and Associate Dean for research in the college. Since January 2020, I've been Chair of the Department of Emergency Medicine at Ohio State. This has given me the opportunity to observe and participate in the success of so many of our faculty and has been a great honor.