TY - JOUR
T1 - The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia
AU - Miedema, Karin G.E.
AU - De Bont, Eveline S.J.M.
AU - Elferink, Rob F.M.Oude
AU - Van Vliet, Michel J.
AU - Nijhuis, Claudi S.M.Oude
AU - Kamps, Willem A.
AU - Tissing, Wim J.E.
PY - 2011/10
Y1 - 2011/10
N2 - 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.
AB - 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.
KW - Bacterial infection
KW - Biomarkers
KW - Children
KW - Febrile neutropenia
KW - Mucositis
UR - http://www.scopus.com/inward/record.url?scp=80052430330&partnerID=8YFLogxK
U2 - 10.1007/s00520-010-0987-6
DO - 10.1007/s00520-010-0987-6
M3 - Article
C2 - 20803037
AN - SCOPUS:80052430330
SN - 0941-4355
VL - 19
SP - 1593
EP - 1600
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 10
ER -