The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia

Karin G.E. Miedema, Eveline S.J.M. De Bont, Rob F.M.Oude Elferink, Michel J. Van Vliet, Claudi S.M.Oude Nijhuis, Willem A. Kamps, Wim J.E. Tissing

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73 Citaten (Scopus)

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Purpose: In this study, we evaluated C-reactive protein (CRP), interleukin (IL)-8, procalcitonin (PCT), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as predictors for bacterial infection in febrile neutropenia, plus their usefulness in febrile neutropenia during chemotherapy-induced gastrointestinal mucositis. Methods: Plasma was obtained from pediatric oncology patients at presentation with febrile neutropenia (n=43) and 24-48 h later (n=17). The patients were classified as having or not having a bacterial infection. Plasma was also obtained of patients in the absence and in the presence of mucositis (n=26). Results: At presentation with febrile neutropenia, median IL-8 and PCT levels were significantly increased in patients with a bacterial infection, in contrast to CRP and sTREM-1. IL-8 was the most sensitive marker for the early detection of bacterial infection, in combination with clinical parameters or PCT the sensitivity reached 100%. After 24-48 h, only PCT was significantly elevated during bacterial infection. IL-8 levels were significantly increased during mucositis. Mucositis did not cause considerable changes in PCT levels. Conclusions: IL-8 is the most useful marker for the early detection of bacterial infections, compared with CRP, PCT, and sTREM-1. IL-8 in combination with clinical parameters or PCT might be even more useful. Gastrointestinal mucositis alone does not affect PCT levels, in contrast to IL-8 levels, and therefore, PCT might be more useful for the detection of bacterial infections during mucositis than IL-8.

Originele taal-2Engels
Pagina's (van-tot)1593-1600
Aantal pagina's8
TijdschriftSupportive Care in Cancer
Volume19
Nummer van het tijdschrift10
DOI's
StatusGepubliceerd - okt. 2011
Extern gepubliceerdJa

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